Despite appropriate passive and active immunization, perinatal transmission of hepatitis B virus (HBV) still occurs in 5%–10% of infants born to women with high levels of viremia who test positive for the hepatitis B e antigen (HBeAg).
Dr Zhongping Duan and colleagues from China evaluated the effects of cesarean section delivery on perinatal transmission of HBV from women who tested positive for the hepatitis B surface antigen (HBsAg).
The team analyzed data from 1409 infants born to HBsAg-positive mothers through vaginal delivery, elective caesarean section, or urgent cesarean section who completed appropriate immunization against HBV.
The prevention was assumed to have failed for infants who were HBsAg positive when they were 7–12 months old, this information was used to assess transmission rates.
The research team observed that HBV infection was transmitted to a smaller percentage of infants born by elective cesarean sections than by vaginal delivery or urgent cesarean section.
Urgent cesarean section had no effect on vertical transmission, compared with vaginal delivery.
|Urgent cesarean section had no effect on vertical transmission|
|Clinical Gastroenterology & Hepatology|
Infants born by elective cesarean sections had a significantly lower rate of vertical transmission than those born by non-elective cesarean sections.
Women with HBV DNA levels <1,000,000 copies/mL did not transmit the infection to their infants, regardless of method of delivery.
The researchers observed no differences in maternal or infant morbidity and mortality among the groups.
Dr Duan's team concludes, "There is a significantly lower rate of vertical transmission of HBV infection to infants delivered by elective cesarean sections, compared with those delivered vaginally or by urgent cesarean section."
"Elective cesarean sections for HBeAg-positive mothers with pre-delivery levels of HBV DNA ≥1,000,000 copies/mL could reduce vertical transmission."