County-level factors, such as higher levels of employment, modified higher individual risk
FRIDAY, Nov. 5, 2021 (HealthDay News) — U.S. hepatitis C virus (HCV) infections among pregnant women grew fastest among White and American Indian/Alaska Native (AI/AN) people without a four-year degree between 2009 and 2019, according to a study published online Oct. 29 in JAMA Health Forum.
Stephen W. Patrick, M.D., from Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues assessed individual and county-level factors associated with HCV among pregnant women and their newborn infants. The analysis included 39,380,122 pregnant women across all U.S. counties from 2009 to 2019.
The researchers found that 0.4 percent of all pregnant women were diagnosed with HCV. Women with HCV were more likely to be White, AI/AN, without a four-year degree, and unmarried. During the study period, the rate of HCV among pregnant women increased from 1.8 to 5.1 per 1,000 live births. In adjusted analyses, higher rates of HCV were associated with identifying as White (adjusted odds ratio [aOR], 7.37) and AI/AN (aOR, 7.94) versus Black, not having a four-year degree (aOR, 3.19), having Medicaid versus private insurance (aOR, 3.27), and being unmarried (aOR, 2.80). A lower risk for HCV was seen with rural residence, higher rates of employment, and greater density of obstetricians. When adjusting for other factors, among individuals at the highest risk for HCV, higher levels of county employment were associated with less of a rise in HCV infections over time.
“As systems are developed to prevent, evaluate, and treat dyads at risk for HCV they should consider both the individual and community risks that may influence risk of acquiring the virus,” the authors write.
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