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Elective cesarean delivery lowers risk of vertical hepatitis B transmission

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Elective cesarean section is associated with a lower rate of mother-to-child transmission of hepatitis B virus (HBV) than is vaginal delivery, according to a report in the August 28th issue of Virology Journal published by BioMed Central.

“Based on our study, we encourage physicians to perform elective cesarean section for preventing mother-to-child transmission of HBV if the pregnant women are patients with high viral loads,” Dr. Lian-san Zhao from West China Hospital of Sichuan University, Chengdu, China told Reuters Health.

Dr. Zhao and colleagues assessed the evidence from randomized controlled trials for any effect on the risk of vertical transmission of HBV when elective cesarean section is offered to HBV-infected mothers.

The systematic review identified four studies conducted in China, involving 789 women. Pooled results showed the rate of mother-to-child transmission of HBV to be significantly lower after elective cesarean section (10.5%) than after vaginal delivery (28.0%), the investigators report.

“If HBV DNA is less than 1000 copies/mL, we suggest performing vaginal delivery,” Dr. Zhao added. “If HBV DNA is more than 1000 copies/mL, we recommend carrying out elective cesarean section.”

There was no postpartum morbidity associated with elective cesarean section, the researchers note. “We conclude that elective cesarean section is relatively effective and safe for preventing mother-to-child transmission of HBV,” Dr. Zhao said.

Reference:
Virol J 2008;5.