(761) Breastfeeding initiation among people with hepatitis C during pregnancy: associated factors and offspring outcomes
Friday, February 10, 2023
10:30 AM – 12:00 PM
Objective: To identify factors associated with breastfeeding initiation and to assess the relationship between breastfeeding and offspring outcomes among people with hepatitis C virus (HCV) during pregnancy
Study Design: Exploratory secondary analysis of a multicenter observational cohort of pregnant people with singleton gestation and HCV seropositivity. The primary outcome was self-reported initiation of breastfeeding or provision of expressed breastmilk. Secondary outcomes were offspring’s biometry through two years of age.Univariable and multivariable analyses were performed.
Results: Data on breastfeeding initiation were available for 587 participants (76% of parent study participants). Eight people were excluded due to HIV co-infection, leaving 579 for final analysis. Of those, 362 (62.5%) initiated breastfeeding or provided breastmilk to their infant, with a median duration of breastfeeding of 1.6 months (IQR 0.7-6.0). People with HCV viremia during pregnancy were less likely to initiate breastfeeding than those who had undetectable viral load (aOR 0.57, 95% CI 0.38-0.86), whereas those who were employed, privately insured, had at least a high school education, and did not use tobacco were more likely to initiate breastfeeding (Table 1). There was no difference in infant biometry at 2-6 months of age. However, children who were breastfed or received breastmilk had higher weight for age z-scores (adjusted mean difference 0.33, 95% CI 0.07-0.58, Table 2) and were more likely to have weight for age z-scores >2 SD (aOR 2.26, 95% CI 1.03-4.97) at 18-24 months than children who were not.
Conclusion: Although HCV seropositivity with viremia is not a contraindication to breastfeeding, rates of breastfeeding initiation are lower among people with viremia than among those with an undetectable viral load, and differed by socioeconomic status. Breastfeeding was associated with improved child growth. Patient and provider education on the safety and benefits of breastfeeding in this population is needed.
Primary & Presenting Author(s)
Jennifer L. Grasch, MD
Fellow The Ohio State University Columbus, Ohio, United States