This type of hepatitis is diagnosed late and has a high rate of chronicization, exceeding 85%.
The vertical transmission rate from the mother to the child is low. The presence of HCV-RNA in the mother at birth is the most important factor associated with vertical transmission. The rate of transmission from mother to child is higher if the mother is HIV positive. Also prolonged rupturing of the membranes may be associated with an increased risk of transmission.
Transmitting antepartum is related to the mother’s degree of infection: in particular the presence of viremia (HCV-RNA).
Studies show a variable risk of trasmission the HCV infection with limits between 5% and 34% depending on the presence of mother viremia.
A number of 54 newborns of positive HCV mothers were tested for hepatitis C in the first 3 days of life, of which 17 (34%) were infected, assuming that the infection was acquired in the uterus. Of the 37 uninfected, 27 were positive for further testing, 3 months after birth.
(Mok J, Pembrey L, Tovo PA, Newell ML. When does mother to child transmission of hepatitis C virus occur?. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2005 Mar 1; 90 (2): F156-60).
A number of 499 women were tested for anti HCV, of them 65 were positive, with 20 of them positive and PCR test. The vertical transmission rate was 5%.
(Kumar RM, Frossad PM, Hughes PF. Seroprevalence and mother-to-infant transmission of hepatitis C in asymptomatic Egyptian women. European Journal of Obstetrics & Gynecology and Reproductive biology. 1997 Dec 1; 75 (2): 177-82).
A study involving 145 positive HCV pregnant women showed a vertical transmission rate of 4.7% among those with positive HCV-RNA, not identifying any of the negative HCV-RNA.
(Money D, Boucoiran I, Wagner E, Dobson S, Kennedy A, Lohn Z, Krajden M, Yoshida EM. Obstetrical and Neonatal outcomes Among Women Infected With Hepatitis C and their infants. Journal of Obstetrics and Gynaecology Canada. 2014 Sep 30; 36 (9): 785-94).
The transmission of intrapartum can be avoided if the birth is achieved by caesarean.
Postpartum transmission has not been proven. Mother’s milk transmission is unknown.
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