Case-control study of risk factors associated with hepatitis C virus infection among pregnant women in hospitals of Karachi-Pakistan

Objective: To identify risk factors for hepatitis C virus (HCV) infection among pregnant women seeking antenatal care in tertiary care hospitals of Karachi, Pakistan. Methods: We enrolled 119 cases and 238 controls. Cases were enzyme-linked immunosorbent assay (ELISA III) positive pregnant women for antibodies to HCV; controls were anti-HCV ELISA negative pregnant women. Results: The mean age of study subjects was 26 years (SD 5) ranging from 15 to 50 years. The mean number of pregnancies for cases was 4 (SD 3) and for controls was 3 (SD 2). Among cases an average number of injections in any month was 40%, history of hospitalization was 61% and household contact with jaundice or hepatitis was 35%. In the final multivariable logistic regression model, five or more gestations (aOR = 1.99; 95% CI = 1.08-3.33), ≥1 injection (aOR = 2.33; 95% CI = 1.38-3.91) per month, hospitalization (aOR = 1.78; 95% CI = 1.01-2.99) and household contact with jaundice/hepatitis (aOR = 3.32; 95% CI = 1.89-5.83) were independently associated with HCV. Conclusion: Iatrogenic exposure (health care injections, hospitalizations and gestations) is the major risk factor for transmission of HCV among pregnant women.