Preliminary assessment of HEV exposure and obstetric outcomes in pregnant women in Moldova

Abstract

Introduction. Hepatitis E virus (HEV) infection is an increasingly recognized public health concern, particularly for pregnant women who are at greater risk of severe disease and adverse pregnancy outcomes. In regions where sanitation and water safety may be variable, understanding the prevalence of HEV and related factors is essential to develop effective preventive strategies. Purpose of the study. This study aimed to assess the seroprevalence of Anti-HEV IgG and IgM antibodies in pregnant women from different geographic areas of Moldova and to explore their obstetric histories, presence of recent clinical symptoms, and previous pregnancy complications. Material and methods. A cross-sectional descriptive study was conducted involving 256 pregnant women from northern, central, and southern regions of Moldova. Each participant underwent serological testing for Anti-HEV IgG and IgM antibodies. Information was also collected regarding the number of previous pregnancies, history of obstetric complications, presence of recent symptoms suggestive of viral infection, and environmental risk exposures such as source of drinking water and contact with animals. Data analysis involved descriptive statistics including frequency distributions and mean values. Results. The seroprevalence of anti-HEV IgG was 6.6% (17 of 256 women), while 5.1% (13 women) tested positive for anti-HEV IgM, indicating recent infection. The majority of participants (64%) resided in the central region, followed by 19% in the north and 17% in the south. The mean number of previous pregnancies was 1.87, with some women having up to nine. Complications in previous pregnancies were reported by approximately 25% of participants, the most common being cesarean sections, antenatal deaths, and pregnancy stagnation. Notably, 75% of women reported no prior complications. Regarding clinical presentation, 94% of women denied recent symptoms, 5.5% reported fatigue, and only one case presented with both fatigue and dark urine. Concerning environmental exposure, most participants used centralized water supplies and denied high-risk behaviors such as consuming undercooked meat or contact with pigs or wild animals. Conclusions. This study revealed a moderate prevalence of HEV exposure among pregnant women in Moldova, with most cases remaining asymptomatic. The findings highlight the importance of continued monitoring of HEV infection, especially among women with complex obstetric histories. Early recognition of HEV exposure, coupled with targeted public health education and improved sanitation measures, may help mitigate adverse outcomes for both mothers and infants.