Breastfeeding Initiation, Duration, and Associated Factors Among People With Hepatitis C Virus Infection

Authors

Jennifer L Grasch
Jessica A de Voest
George R Saade
Brenna L Hughes
Uma M Reddy
Maged M Costantine
Edward K Chien
Alan T N Tita
John M Thorp
Torri D Metz
Ronald J Wapner
Vishakha Sabharwal
Hyagriv N Simhan
Geeta K Swamy
Kent D Heyborne
Baha M Sibai
William A Grobman
Yasser Y El-Sayed
Brian M Casey
Samuel Parry
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network

Publication Date

3-1-2024

Journal

Obstetrics & Gynecology

Abstract

OBJECTIVE: To characterize breastfeeding behaviors and identify factors associated with breastfeeding initiation among people with hepatitis C virus (HCV) infection.

METHODS: We conducted a secondary analysis of a multicenter observational cohort of pregnant people with singleton gestations and HCV seropositivity. This analysis includes individuals with data on breastfeeding initiation and excludes those with human immunodeficiency virus (HIV) co-infection. The primary outcome was self-reported initiation of breastfeeding or provision of expressed breast milk. Secondary outcomes included duration of breastfeeding. Demographic and obstetric characteristics were compared between those who initiated breastfeeding and those who did not to identify associated factors. Univariable and multivariable analyses were performed.

RESULTS: Overall, 579 individuals (75.0% of participants in the parent study) were included. Of those, 362 (62.5%) initiated breastfeeding or provided breast milk to their infants, with a median duration of breastfeeding of 1.4 months (interquartile range 0.5-6.0). People with HCV viremia , defined as a detectable viral load at any point during pregnancy, were less likely to initiate breastfeeding than those who had an undetectable viral load (59.4 vs 71.9%, adjusted odds ratio [aOR] 0.61, 95% CI, 0.41-0.92). People with private insurance were more likely to initiate breastfeeding compared with those with public insurance or no insurance (80.0 vs 60.1%; aOR 2.43, 95% CI, 1.31-4.50).

CONCLUSION: Although HCV seropositivity is not a contraindication to breastfeeding regardless of viral load, rates of breastfeeding initiation were lower among people with HCV viremia than among those with an undetectable viral load.

Keywords

Infant, Pregnancy, Female, Humans, Breast Feeding, Hepacivirus, Viremia, Hepatitis C, HIV Infections

Comments

Clinical Trial Registration: NCT01959321

PMID: 38176013