No evidence of intrauterine transmission of hepatitis A virus from a mother to a premature infant

• Published in: Acta Paediatrica Vol. 98; no. 10; pp. 1603 - 1606
• Main Authors: Selander, Bo, Bläckberg, Jonas, Widell, Anders, Johansson, PJ Hugo
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2009; Blackwell
• Subjects: Adult; Biological and medical sciences; Clinical Medicine; Female; General aspects; Hepatitis A - transmission; Hepatitis A Antibodies - blood; Hepatitis A virus; Hepatitis A virus - isolation & purification; Human viral diseases; Humans; Infant, Newborn; Infant, Premature; Infectious Disease Transmission, Vertical; Infectious diseases; Intrauterine infection; Klinisk medicin; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Milk, Human - chemistry; Pediatrics; Pediatrik; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Trimester, Third; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral - analysis; RNA, Viral - blood; Viral diseases; Viral hepatitis; Viremia; Premature; Pediatrics; Hepatitis A virus; Picornaviridae; Hepatic disease; In utero; Hepatovirus; Infection; Virus; Viral hepatitis A; Uterus; Viral disease; Nitric oxide; Female genital system; Digestive diseases; Vertical transmission; Intrauterine infection
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/j.1651-2227.2009.01402.x

Aim:  To determine whether or not an intrauterine transmission of hepatitis A virus (HAV) occurred from an infected mother to her premature infant delivered by caesarean section. Methods:  The mother and her child were tested for HAV by serology and reverse transcription PCR. Results:  An outbreak of HAV infection was seen among children and a 33‐year‐old day‐care teacher, pregnant in third trimester, at a day‐care centre in southern Sweden. Due to premature labour and diminished foetal movements a caesarean section was performed and a premature girl in gestational weeks 33 + 1 was born. During the 3‐week postnatal hospitalization period the child presented no clinical symptoms of HAV infection and anti‐HAV IgM antibodies remained undetectable at day 14 and 109 after birth. Furthermore HAV RNA remained undetectable by reverse transcription PCR in the child’s blood at birth and in throat and faeces for the first 3 and 4 weeks of life respectively. HAV RNA in the mother’s blood was detected at 6 days prior to and at 17 days after delivery. HAV RNA was undetectable in breast milk when tested on day 3 after delivery. Conclusion:  There was no evidence of intrauterine transmission of hepatitis A virus from a viraemic mother to her premature child delivered at gestational week 33 + 1 by caesarean section.