Infection with hepatitis E virus (HEV) not only causes more severe liver disease in pregnant women, leading to a six times higher maternal mortality rate than that of non-HEV-infected women (RR, 6.0; CI, 2.7–13.3; P<0.001), but pregnant women with HEV are four times more likely to have an antepartum hemorrhage and twice as likely to experience intrauterine fetal death as women with other forms of acute viral hepatitis, according to the findings of an observational, cohort study conducted in India.
Researchers included approximately 220 pregnant women presenting with jaundice caused by acute viral hepatitis, 60% of which were infected with HEV. Fulmi-nant hepatic failure was almost three times more common (RR, 2.7; 95% CI, 1.7–4.2; P=0.001) among the HEV-infected women compared with the non-HEV-infected women. The HEV-infected women were also at higher risk for stillbirth (RR, 1.8; CI, 1.2–2.5; P=0.026).
Patra S, Kumar A, Trivedi SS, et al. Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med. 2007;147:28-33.