@article{3133858,
    title = "Effects of mode of delivery and infant feeding on the risk of mother-to-child transmission of hepatitis C virus: European Paediatric Hepatitis C Virus Network",
    author = "Tovo, P.-A. and Newell, M.-L. and Coll, O. and de Tejada, B.M. and Lanari, M. and Bosi, I. and Papa, I. and Zanetti, A. and Contreras, J.R. and Manzanares, A. and Ramos, J.T. and Vegnente, A. and Iorio, R. and Fabris, C. and Bandelloni, A.M. and Tibaldi, C. and Ciria, L.M. and Palomba, E. and Riva, C. and Scolfaro, C. and Buffolano, W. and Scotese, I. and Micco, A. and Marcellini, M. and Sartorelli, M.R. and Mattia, S. and Bohlin, A.-B. and Fischler, B. and Lindgren, S. and Lindh, G. and Maccabruni, A. and Pacati, I. and Arlandi, L. and Polywka, S. and Butler, K. and De Maria, A. and Bassetti, D. and Fioredda, F. and Boni, S. and Gotta, C. and Mazza, A. and Grosch-Wörner, I. and Sperling, C.F. and Quinti, I. and Scaravelli, G. and Cigna, P. and Cilla, G. and Echeverria, J. and Souayah, H. and Grossman, D. and Levy, J. and Bona, G. and Mok, J.Y.Q. and Fontelos, P.M. and Arrieta, J.V. and Asensi-Botet, F. and Otero, M.C. and Pérez-Tamarit, D. and Zuin, G. and Saccani, B. and Zuccotti, G.V. and Riva, E. and Gamboni, A. and Wejstal, R. and Norkrans, G. and Scherpbier, H. and Mûr, A. and Viñolas, M. and Extremera, A.R. and Roura, L.C. and McBertran Sanges, J. and McLeon Leal, J.A. and Rodriguez, A. and Sarrión-Auñón, A. and Corrias, A. and Boucher, C. and Hatzakis, A. and Grella, P.",
    journal = "British Journal of Obstetrics and Gynaecology",
    year = "2001",
    volume = "108",
    number = "4",
    pages = "371-377",
    issn = "0306-5456",
    doi = "10.1016/S0306-5456(00)00088-7",
    keywords = "adult;  article;  bottle feeding;  breast feeding;  cesarean section;  child;  comparative study;  delivery;  hepatitis C;  Hepatitis C virus;  human;  Human immunodeficiency virus infection;  infant feeding;  infection risk;  major clinical study;  priority journal;  retrospective study;  superinfection;  vaginal delivery;  virus transmission, Adult;  Bottle Feeding;  Breast Feeding;  Cesarean Section;  Delivery, Obstetric;  Disease Transmission, Vertical;  Female;  Hepatitis C;  Humans;  Infant;  Infant, Newborn;  Pregnancy;  Pregnancy Complications, Infectious;  Prospective Studies;  Retrospective Studies;  Risk Factors",
    abstract = "Objective: To investigate the effects of mode of delivery and infant feeding on the risk of mother-to-child transmission of hepatitis C virus. Design: Pooled retrospective analysis of prospectively collected data. Sample: Data on hepatitis C virus seropositive mothers and their children identified around delivery were sent from 24 centres of the European Paediatric Hepatitis C Virus Network. Main outcome measures: Hepatitis C virus infection status of children born to hepatitis C virus infected women. Results: A total of 1,474 hepatitis C virus infected women were identified, of whom 503 (35%) were co-infected with HIV. Co-infected women were more than twice as likely to transmit hepatitis C virus to their children than women with hepatitis C virus infection alone. Overall 9.2% (136/1474) of children were hepatitis C virus infected. Among the women with hepatitis C virus infection-only, multivariate analyses did not show a significant effect of mode of delivery and breastfeeding: caesarean section vs vaginal delivery OR = 1.17, P: 0.66; breastfed versus non-breastfed OR = 1.07, P = 0.83. However, HIV co-infected women delivered by caesarean section were 60% less likely to have an infected child than those delivered vaginally (OR = 0.36, P = 0.01) and those who breastfed were about four times more likely to infect their children than those who did not (OR = 6.41, P: 0.03). HIV infected children were three to four times more likely also to be hepatitis C virus infected than children without HIV infection (crude OR = 3.76, 95% CI 1.89-7.41). Conclusions: These results do not support a recommendation of elective caesarean section or avoidance of breastfeeding for women with hepatitis C virus infection only, but the case for HIV infected women undergoing caesarean section delivery and avoiding breastfeeding is strengthened if they are also hepatitis C virus infected."
}