(1071) Marked 21-year decline in infectious diseases in pregnancy at the busiest maternity hospital in Europe

This hospital provides a specialist multidisciplinary service to manage pregnancies complicated by certain infectious diseases. We interrogated a prospectively collected database for prevalence of these infections in pregnancy, incidence of newly diagnosed cases, and data on infected neonates. Comparisons were made across a 21 year time period using the Cochran-Armitage Test of Trend.


Results:

Figure 1 demonstrates the incidence of new cases of Hepatitis B (HBV), Hepatitis C (HCV), syphilis and HIV in pregnancy during the last 21 years of operation of this specialist clinic, while Figure 2 shows the prevalence of each infection (new and pre-existing). There has been a significant decrease in the prevalence of all infections, with HBV declining from 14.5/1,000 in 2002 to 4.2/1,000 in 2022 (p< 0.0001), HCV declining from 11.5/1,000 in 2002 to 2.0/1,000 in 2022 (p< 0.0001), syphilis declining from 5.6/1,000 in 2002 to 2.5/1,000 in 2022 (p< 0.0001), and HIV declining from 7.3/1,000 in 2002 to 1.4/1,000 in 2022 (p< 0.0001). Similarly, declines were noted in the number of newly diagnosed cases for all infections over the 21 year time period. The number of infected neonates has remained low, with only one case of a neonate infected with HCV and one with syphilis in the last five years from 2018-2022 and no cases of neonates infected with HBV or HIV.


Conclusion: There has been a marked reduction in incidence of HBV, HCV, syphilis and HIV in pregnancy over the last 21 years at the largest obstetric hospital in Europe. While it is reassuring to note such a significant drop in maternal infection, it is even more reassuring to see an almost complete absence of congenital infection with these infections. This likely underscores the critical importance of maintaining such a multidisciplinary specialist infectious diseases in pregnancy service.