SynthesisCanadian journal of gastroenterology & hepatology2014
Caesarean section to prevent transmission of hepatitis B: a meta-analysis.
Synthesis in Canadian journal of gastroenterology & hepatology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Cesarean section to prevent mother-to-child transmission of hepatitis B virus in China: A meta-analysis.BMC pregnancy and childbirth · 2017Pooled it
- Breaking the chain of perinatal hepatitis B transmission: Editorial on "Factors associated with hepatitis B mother-to-child transmission in a national prevention program".Clinical and molecular hepatology · 2026Article
- Factors associated with hepatitis B mother-to-child transmission in a national prevention program.Clinical and molecular hepatology · 2025Article
- Caesarean section and risk of infection in offspring: systematic review and meta-analysis of observational studies.BMJ medicine · 2024Article
- Maternal Hepatitis B Infection Burden, Comorbidity and Pregnancy Outcome in a Low-Income Population on the Myanmar-Thailand Border: A Retrospective Cohort Study.Journal of pregnancy · 2019Article
- Novel insights in the prevention of perinatal transmission of hepatitis B.World journal of hepatology · 2018Article
- Current evidence on the management of hepatitis B in pregnancy.World journal of hepatology · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVertical transmission of hepatitis B virus (HBV) occurs in up to 10% to 20% of births.
objectiveTo assess whether Caesarean section, compared with vaginal delivery, prevents HBV transmission.
methodsA systematic review and meta-analysis was conducted. Two investigators independently searched PubMed, EMBASE and other databases for relevant studies published between 1988 and 2013. A manual search of relevant topics and major conferences for abstracts was also conducted. Randomized trials, cohort and case-control studies assessing the effect of delivery mode on vertical transmission of HBV were included. Studies assessing antiviral therapy and patients with coinfection were excluded. The primary outcome was HBV transmission rates according to delivery method.
resultsOf the 430 studies identified, 10 were included. Caesarean section decreased the odds of HBV transmission by 38% compared with vaginal delivery (OR 0.62 [95% CI 0.40 to 0.98]; P=0.04) based on a random-effects model. Significant heterogeneity among studies was found (I²=63%; P=0.003), which was largely explained by variation in hepatitis B immune globulin (HBIG) administration. Meta-regression showed a significant linear association between the percentage of infants receiving HBIG per study and the log OR (P=0.005), with the least benefit observed in studies with 100% HBIG administration. Subgroup analysis of hepatitis B e-antigen-positive women who underwent Caesarean section did not show a significant reduction in vertical transmission. DISCUSSION: Caesarean section may protect against HBV transmission; however, convincing benefit could not be demonstrated due to significant study heterogeneity from variable HBIG administration, highlighting the importance of HBIG in HBV prevention.
conclusionMore high-quality studies are needed before any recommendations can be made.
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