Hepatitis B in Pregnancy and Prevention of Perinatal Hepatitis B
The resources presented here offer health care professionals current information about reporting and management of hepatitis B infection in pregnancy and prevention of perinatal transmission of hepatitis B to newborns.
Hepatitis B Birth Dose Coverage by NYC Facility:
Reporting Hepatitis B in Pregnancy
NYC Providers who identify pregnant women infected with hepatitis B virus are required by New York State law, as well as NYC Health Code to report those cases to NYC DOHMH
Reports may be submitted electronically or via paper reports, additional details on reporting via either method are provided below:
- Electronic Reporting – Providers can report cases of Hepatitis B in pregnancy on-line by filling out an electronic URF (eURF) for Perinatal Hepatitis B. This is the preferred method. For instructions on how to complete an eURF click here.
- Paper Reporting – If unable to report on line, providers may report cases of hepatitis B infection in pregnancy via the IMM-5 reporting form (PDF).
Identification and Management of Hepatitis B Infection in Pregnancy
- New York State Public Health Law 2500-e, mandates that all pregnant women be screened for hepatitis B surface antigen (HBsAg) during pregnancy (preferably in the 1st trimester)
- When ordering hepatitis B virus testing, prenatal care providers should make a note of pregnancy status as part of clinically relevant information on the lab requisition
- Prenatal care providers should include the hepatitis B status of pregnant women in the prenatal chart and provide a copy of the original HBsAg laboratory report to the expected hospital of delivery
- HBsAg-negative women who are at risk for HBV infection (non-immune, multiple sexual partners or injection drug use) during pregnancy should be offered hepatitis B vaccination and retested for HBsAg at the time of delivery
- HBsAg-positive patients should be referred to a specialist for evaluation of their chronic hepatitis B infection
- Sexual and household contacts of HBsAg-positive patients should be screened for hepatitis B and vaccinated if susceptible.
Prevention of Perinatal Transmission of Hepatitis B Infection
- All infants born to HBsAg-positive mothers should be administered hepatitis B immune globulin (HBIG) and the 1st dose of hepatitis B vaccine within 12 hours of birth, these infants should receive their 2nd dose of hepatitis B vaccine at 1 month of age
- Infants born to women with unknown HBsAg status should be administered the 1st dose of hepatitis B vaccine (without HBIG) if results of HBsAg testing are not available within 12 hours of birth. If the mother is determined to be HBsAg positive, HBIG should be administered as soon as possible and no later than age 7 days.
- Standard of care is that all other infants should receive their first dose of hepatitis B vaccine no later than at the time of discharge from the birthing hospital
- Infants born to HBsAg-positive mothers should complete the hepatitis B vaccination series following the recommended routine childhood immunization schedule
- All children born to hepatitis B infected mothers should be tested for both HBsAg and hepatitis B surface antibody (anti-HBs) at 9 months of age. The hepatitis B test results for the infant should be reported the same as Reporting Hepatitis B in Pregnancy , outlined above
Hepatitis B Vaccine Birth Dose Information for Hospitals
Hepatitis B Vaccine Patient – Slide-sets
- Hepatitis B and a Healthy Baby (two slide-sets for hepatitis B infected pregnant women)
Hepatitis B Patient Handouts
Prevention of Perinatal Hepatitis B for Healthcare Professionals
- New York State Public Health Law - Section 2500-E (PDF)
- New York City Health Code - SubPart 69-3
- A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States Recommendations of the Advisory Committee on Immunization Practices (ACIP) Part 1: Immunization of Infants, Children, and Adolescents, MMWR, December 23, 2005/54(RR16) (PDF)
- Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection, MMWR, September 19, 2008/57(RR08)
- Action Plan for the Prevention, Care, & Treatment of Viral Hepatitis, 2014-2016, Office of HIV/AIDS and Infectious Diseases, U.S. Department of Health and Human Services (PDF)
- National Center for HIV/AIDs, Viral Hepatitis, STD, and TB Prevention, Strategic Plan Through 2020 (PDF)
- New York State Department of Health Perinatal Hepatitis B Prevention Program Manual (PDF)
For Prenatal Care Providers
For Laboratories and Infection Control
For Delivery Facilities