Am J Perinatol 2020; 37(09): 881-889
DOI: 10.1055/s-0039-3402753
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of Needle Exchange Program on Maternal Hepatitis C Virus Prevalence

Robert M. Rossi
1  Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
2  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
,
Matthew J. Brady
1  Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
,
3  Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
4  Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Carri R. Warshak
1  Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
2  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
› Author Affiliations
Further Information

Publication History

03 August 2019

02 December 2019

Publication Date:
21 January 2020 (online)

Abstract

Objective This study aimed to quantify the prevalence of maternal hepatitis C virus (HCV) before and after implementation of the needle exchange program (NEP) in Scioto County, Ohio.

Study Design We conducted a population-based retrospective cohort study of all live births in Ohio (2006–2015). Frequency of maternal HCV was compared before (2006–2011) and after (2012–2015) the implementation of an NEP (2011) in Portsmouth, Ohio (Scioto County). Trends in maternal HCV prevalence in neighboring counties both physically adjacent and regional to Scioto County were also evaluated before and after NEP implementation.

Results During the study period, there were 7,069 reported cases of maternal HCV infection at the time of delivery among 1,463,506 (0.5%) live births in Ohio. The rate of maternal HCV infection increased 137% in Scioto County between 2006 and 2011. After initiation of the NEP in Portsmouth, Ohio, in 2011, the rate of increase in the following 4 years (2012–2015) was 12%. The rate of increase in maternal HCV declined precipitously in counties physically adjacent to Scioto County, whereas regional counties continued to have substantial increases in maternal HCV.

Conclusion Rate of maternal HCV infection increased 137% versus 12% (rate difference: 125%) between pre- and post-NEP implementation time periods in Scioto County.

Precis

Maternal HCV increased 137% between 2006 and 2011 in Scioto County, Ohio. After emergency implementation of an NEP in Portsmouth (Scioto County) in 2011, the rate of increase dropped precipitously over the next 4 years (2012–2015) to 12%. Between 2014 and 2015, the maternal HCV rate even decreased by 6%.


Note

This study was presented at the ACOG Annual Clinical and Scientific Meeting, May 3–5, 2019, Nashville, TN. This study includes data provided by the Ohio Department of Health, which should not be considered an endorsement of this study or its conclusions. Each author has confirmed compliance with the journal's requirements for authorship.