The effectiveness of screening for hepatitis C in pregnancy.

Objective: to determine the effectiveness of universal versus targeted screening for hepatitis C (HCV) during pregnancy at an urban health care centre.
Methods: we conducted a cross-sectional study of 653 pregnant women. Patients completed a demographic and standardized questionnaire identifying known risk factors for HCV. Patients then underwent blood testing for HCV antibodies. The effectiveness of screening based on risk factors was determined by comparing the number of women who screened positive for HCV risk factors with those who tested seropositive.
Results: of those who entered the study, 0.5% (3/645) tested positive for HCV. HCV risk factor screening showed that 72% answered "Yes" to one or more risk factors and 28% answered "No" to all risk factors. Answering "Yes" to any risk factor was not associated with testing positive for HCV antibodies (P > 0.05). Screening positive for a high severity risk factor (exposure to intravenous drug use or to the blood of an HCV-positive individual) was associated with testing positive for HCV antibodies (P = 0.002), but screening positive for a moderate or low severity risk factor was not (P > 0.05).
Conclusion: during pregnancy, universal testing for HCV and testing based on the presence of any risk factors for HCV is not recommended. HCV testing based on the presence of high severity risk factors, however, may be warranted.