Sharing of Snorting Straws and Hepatitis C Virus Infection in Pregnant Women

Obstet Gynecol. 2016 Aug;128(2):234-237. doi: 10.1097/AOG.0000000000001507.


Objective: To evaluate possible modes of hepatitis C virus (HCV) acquisition in pregnant women found to be HCV-infected in the prenatal period and to assess transmission risk factors.

Methods: This was a prospective cohort study conducted from March 2014 through June 2015 involving the distribution of an anonymous survey to HCV-infected pregnant women that assessed for numerous modes of potential HCV transmission involving, intravenous drug use, blood transfusion, organ transplant, sexual contact, tattoos, and snorting drugs with a straw. Participants were drawn from our institutional obstetric high-risk clinic. Statistical analysis involved simple percentages and χ comparisons where appropriate; P<.05 was considered significant. To test biologic plausibility, snorting utensils confiscated by law enforcement authorities from patients not in this study were tested for the presence of human blood.

Results: A total of 189 HCV-infected pregnant patients completed the survey, and no approached patients declined. Of these, 136 (72%, 95% confidence interval [CI] 65-78%) admitted to intravenous drug use, of whom 89 (65%, 95% CI 57-73%) reported sharing needles. Of the 178 (94%, 95% CI 90-97%) who admitted snorting drugs, 164 (92%, 95% CI 87-96%) reported sharing straws. The difference between the proportion reporting sharing of snorting utensils compared with the proportion sharing intravenous drug use utensils was significant (P<.001). Twenty-nine patients (15%, 95% CI 11-21%) reported snorting drugs and sharing straws but denied any other risk factor except sexual contact. Of the 54 straws confiscated by law enforcement authorities, 13 (24%, 95% CI 13-38%) tested positive for the presence of human blood.

Conclusion: Sharing snorting utensils (straws) in noninjection drug use may be an additional risk factor for HCV and other virus transmission.

MeSH terms

  • Administration, Intranasal / instrumentation
  • Adult
  • Blood
  • Equipment Contamination*
  • Female
  • Fomites
  • Hepatitis C / transmission*
  • Humans
  • Needle Sharing / statistics & numerical data
  • Pregnancy
  • Pregnancy Complications, Infectious / virology*
  • Prospective Studies
  • Risk Factors
  • Sexual Behavior
  • Substance Abuse, Intravenous / complications
  • Substance-Related Disorders / complications*
  • Surveys and Questionnaires