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Meta-Analysis
. 2016 Jul;144(10):2098-106.
doi: 10.1017/S0950268816000418. Epub 2016 Mar 4.

Case-fatality risk of pregnant women with acute viral hepatitis type E: a systematic review and meta-analysis

H Jin  1 , Y Zhao  2 , X Zhang  3 , B Wang  3 , P Liu  2
Affiliations
Meta-Analysis

Case-fatality risk of pregnant women with acute viral hepatitis type E: a systematic review and meta-analysis

H Jin et al. Epidemiol Infect. 2016 Jul.

Abstract

It is of great concern that pregnant women with acute viral hepatitis (AVH) type E have serious consequences. This study aimed to estimate the case-fatality risk (CFR) and potential risk factors of pregnant women with AVH type E. We searched the PubMed, EMBASE, and Web of Science databases for studies containing data on CFR in pregnancy with AVH type E. A pooled estimate of CFR was calculated using a random-effects model. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis, and meta-regression. We identified 47 eligible studies with a total African and Asian population of 3968 individuals. The pooled CFRs of maternal and fetal outcomes were 20·8% [95% confidence interval (CI) 16·6-25·3] and 34·2% (95% CI 26·0-43·0), respectively. Compared with these, the pooled CFR was highest (61·2%) in women with fulminant hepatic failure (FHF). Community-based surveys had lower pooled CFR (12·2%, 95% CI 9·2-15·6) and heterogeneity (25·8%, 95% CI 20·1-32·0) than hospital-based surveys. Univariate analysis showed that hospital-based surveying (P = 0·007), and patients in the third trimester of pregnancy or with FHF (P < 0·05), were significantly associated with CFR. Intrauterine fetal mortality (27·0%) was statistically higher than neonatal mortality (3·9%). Control measures for HEV infection would reduce feto-maternal mortality in Asia and Africa.

Keywords: Acute viral hepatitis E; case-fatality risk; meta-analysis; pregnancy.

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Figures

Fig. 1.
Fig. 1.
Selection of 47 articles for a study of the case-fatality risk of pregnant women with acute viral hepatitis E, 1986–2014.
Fig. 2.
Fig. 2.
Forest plot of the case-fatality risk of pregnant women with acute viral hepatitis E, 1986–2014 (included studies are described in the Supplementary material).
Fig. 3.
Fig. 3.
Forest plot of fetal case-fatality risk of pregnant women with acute viral hepatitis E, 1986–2014 (included studies are described in the Supplementary material).
See this image and copyright information in PMC

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