Japanese Foundation for Research and Promotion of Endoscopy

The present study investigated the prevalence of pregnant hepatitis B (HBV) and hepatitis C (HCV) carriers and their internal medicine consultation rates in Japan. A questionnaire was sent to 1931 delivery facilities regarding their delivery management policies and care of pregnant HBV and HCV carriers who delivered between January and December 2023, including internal medicine consultation rates. Responses were received from 1077 facilities (55.8%). The prevalence of HBV was 0.14% in Japanese women (406/288847) and 3.00% (196/6527) in non-Japanese women. The prevalence of HBV in 12 Japanese teenagers (≤19 years) was 0.53%, which was significantly higher than that in adult pregnant women (0.14%) (p < 0.001). HBe antigen was positive in 12.6% of pregnant HBV carriers. The overall prevalence of HCV was 0.23% (684/295374), with similar rates in Japanese and non-Japanese women (0.23% vs. 0.31%), and 3.1% (21/684) had high HCV-RNA levels. Internal medicine consultations were performed on 64.8% (295/455) of known HBV carriers before pregnancy and on 66.7% (98/147) of those diagnosed during pregnancy. Regarding HCV, consultation rates were 10.5% (68/645) before pregnancy and 69.2% (27/39) during pregnancy. The prevalence of pregnant hepatitis virus carriers in Japan is approximately 0.2% for both HBV and HCV, with a high HBV rate in teenagers. Only 60%-70% of patients receive proper internal medicine consultations, highlighting the need for increased awareness among patients, physicians, and healthcare systems.

Chlamydia trachomatis (CT) infection in pregnancy can cause maternal disease, adverse pregnancy outcomes, and neonatal disease [1-6]. In general, approximately 80% of CT infected women are asymptomatic or minimally symptomatic. There-fore, screening is the only means to effectively identify infec-tions [2]. In Japan, pregnant women are routinely tested for CT with the Japanese public funds. According to the guide-lines for obstetrical practice in Japan [7], Japanese obstetri-cians must provide a test for the detection of CT for the pre-vention of neonatal CT infection and diagnose urogenital CT infection when CT is detected using polymerase chain reac-tion (PCR), strand displacement amplification, transcription mediated amplification, an enzyme immunoassay, or culture methods in specimens obtained from the uterine cervix (CT nucleic acid detection tests). However, CT antibody detection by IgA tests has been substituted for these methods by some of obstetricians.On October 2014, we requested 2,544 obstetrical facilities that are members of Japan Association of Obstetricians and Gynecologists (JAOG) to provide information of CT screen-ing tests in pregnant women between October 2013 and March 2014. A total of 1,644 (64.6%) of 2,544 obstetrical facilities responded with possible statistical analysis information on a total of 328,788 women, accounting for approximately 65% of all deliveries that occurred in Japan during the study period. Of the 1,644 obstetrical facilities, CT nucleic acid detection PCR tests, CT nucleic acid detection tests except PCR and CT antibody detection tests were performed in 1,221 (74.3%), 408 (24.8%) and 15 (0.9%) facilities, respectively.Table 1 shows the maternal age distribution under the three CT screening tests (CT nucleic acid detection tests with and without PCR and CT antibody detection tests). There were no significant differences in the maternal age distribution among the three CT screening tests groups.Table 2 shows the results of CT screening tests (CT nucle-ic acid detection tests with and without PCR and CT antibody detection tests) of the study population by age. There were no significant differences in the rate of positive CT between the two groups of CT nucleic acid detection screening tests with and without PCR. However, the positive rate by the CT anti-body detection tests was significantly higher than those by the two CT nucleic acid detection tests with and without PCR (P < 0.01 by X