Outcome of Hepatitis-E Virus Infection among Pregnant Women Admitted in a Tertiary Care Hospital

  • Tayyaba Wasim
  • Javeria Mushtaq
  • Mustafa Wasim
Keywords: HEV, Hepatitis E infection, HEV infection, Pregnancy.


Objective: To evaluate hepatitis E infection outcomes among pregnant women admitted in a tertiary care hospital.
Materials and Methods:
Study Design: Cross-sectional study
Study Setting: Department of Gynecology and Obstetrics Unit I, Services Institute of Medical Sciences, Lahore
Study Duration: May 2019 to Feb 2020, After approval from Institutional Review Board.
Data Collection Procedure: 30 Pregnant women with Hepatitis E confirmed on ELISA IgM, fulfilling the inclusion criteria age, 25 – 40 years of age in any trimester of pregnancy will be included in the study through Non-probability / convenience sampling. Data was entered and analyzed in SPSS ver: 25.0 Qualitative variables like Socio-demographic details and Clinical variables like the feto-maternal outcome were presented as frequency and percentages. The outcome was cross-tabulated with the demographic and clinical profiles. Chi-square test was applied with p < 0.05 was taken as a statistically significant
Results: 30 patients were recruited for the study. 96.7% were between the ages of 18- 40 years. 43.3% were primigravida. 76.7% were delivered through spontaneous vaginal delivery. 66.7% had coagulation defects, Fetal outcomes showed 63.3% were alive, 20.0% were still-birth and 16.7% had ENND. The maternal outcome was 96.7% recovered from Hepatitis E. 14.3% of pregnant women who were delivered with LSCS died which was statistically significant. (p=.045).
Conclusions: The present findings suggest a high Hepatitis E infectivity in pregnancy results in considerable high maternal and fetal morbidity and mortality. This high disease burden can be minimized by the provision of clean drinking water and access to better sanitary conditions for pregnant women.


1. Rein DB, Stevens GA, Theaker J, Wittenborn JS, Wiersma ST. The global burden of hepatitis E virus genotypes 1 and 2 in 2005. Hepatology. 2012;55(4):988–97.
2. Khuroo MS. Discovery of hepatitis E: the epidemic non-A, non-B hepatitis 30 years down the memory lane. Virus Res. 2011;161(1):3–14. Epub 2011 Feb 12.
3. Aggarwal R, Gandhi S. The global prevalence of hepatitis E virus infection and susceptibility: a systematic review. Geneva, Switz: World Health Organization; 2010.
4. Xia H, Wahlberg N, Belák S, Meng XJ, Liu L. The emergence of genotypes 3 and 4 hepatitis E virus in swine and humans: a phylogenetic perspective. Arch Virol. 2011;156(1):121–4. Epub 2010 Oct 7.
5. Prasad GS, Prasad S, Bhupali A, Patil AN, Parashar K. A Study of Hepatitis E in Pregnancy: Maternal and Fetal Outcome. J Obstet Gynaecol India. 2016;66(Suppl 1):18-23
6. Singh S, Mohanty A, Joshi YK, Dwivedi SN, Deka D. Outcome of hepatitis E virus infection in Indian pregnant women admitted to a tertiary care hospital. Indian J Med Res. 2001;113:35-39.
7. Gurley ES, Hossain MJ, Paul RC, et al. Outbreak of hepatitis E in urban Bangladesh resulting in maternal and perinatal mortality. Clin Infect Dis. 2014;59(5):658-665. doi:10.1093/cid/ciu383
8. Tejada-Strop A, Tohme RA, Andre-Alboth J, Childs L, Ji X, Landgraf DO, De Castro V, Boncy J, Kamili S. Seroprevalence of hepatitis a and hepatitis e viruses among pregnant women in Haiti. Am J Trop Med Hyg. 2019;101(1):230–2.
9. Rein DB, Stevens GA, Theaker J, Wittenborn JS, Wiersma ST. The global burden of hepatitis E virus genotypes 1 and 2 in. Hepatology (Baltimore, Md) 2012. 2005;55(4):988–97.
10. WHO: Hepatitis E vaccine: WHO position paper, May 2015. http://www.who.int/wer/2015/wer9018.pdf?ua=1. Accessed 14 July 2020
11. De Paschale M, Ceriani C, Romanò L, Cerulli T, Cagnin D, Cavallari S, Ndayake J, Zaongo D, Diombo K, Priuli G, et al. Epidemiology of hepatitis E virus infection during pregnancy in Benin. Trop Med Int Health. 2016;21(1):108–13.
12. Abebe M, Ali I, Ayele S, Overbo J, Aseffa A, Mihret A. Seroprevalence and risk factors of Hepatitis E Virus infection among pregnant women in Addis Ababa, Ethiopia. PLoS One. 2017;12(6).
13. Farshadpour F, Taherkhani R, Ravanbod MR, Eghbali SS, Taherkhani S, Mahdavi E. Prevalence, risk factors and molecular evaluation of hepatitis E virus infection among pregnant women resident in the northern shores of Persian Gulf, Iran. PLoS One. 2018;13(1).
14. World Health Organization. Global Health sector strategy on viral hepatitis 2016-2021: Towards ending viral hepatitis. WHO: 2016. https://apps.who.int/iris/bitstream/handle/10665/246177/WHO-HIV-2016.06-eng.pdf;jsessionid=8BBB114FF64FC1E901805FA54462BE1?sequence=1.
15. Solanke D, Rathi C, Pandey V, Patil M, Phadke A, Sawant P. Etiology, clinical profile, and outcome of liver disease in pregnancy with predictors of maternal mortality: a prospective study from Western India. Indian J Gastroenterol. 2016;35(6):450–8.
16. Sahai S, Mishra V, Ganga D, Jatav OP. Viral hepatitis in pregnancy--a study of its effect on maternal and Foetal outcome. J Assoc Physicians India. 2015;63(1):28–33.
17. Obiri-Yeboah D, Awuku YA, Adu J, Pappoe F, Obboh E, Nsiah P, Amoako-Sakyi D, Simpore J. Sero-prevalence and risk factors for hepatitis E virus infection among pregnant women in the Cape Coast Metropolis, Ghana. PLoS One. 2018;13(1).
18. Kumar N, Das V, Agarwal A, Pandey A, Agrawal S. Fetomaternal outcomes in pregnant women with hepatitis e infection; still an important fetomaternal killer with an unresolved mystery of increased virulence in pregnancy. Turk Jinekoloji Obstet Dernegi Dergisi. 2017;14(2):106–13.
How to Cite
Wasim T, Mushtaq J, Wasim M. Outcome of Hepatitis-E Virus Infection among Pregnant Women Admitted in a Tertiary Care Hospital. JRMC [Internet]. 30Jun.2022 [cited 24Sep.2022];26(2):306-10. Available from: http://www.journalrmc.com/index.php/JRMC/article/view/1882