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Pregnancy and HBV

ALL pregnant women should be screened for hepatitis B before delivery. It is crucial to identify pregnant women who have hepatitis B in order to protect their unborn child from the virus.

  • Testing is especially important for women who fall into a  high-risk group. This could be due to a woman's ethnic background, occupation, or lifestyle.
  • If a woman tests negative for hepatitis B, then vaccination can be considered if she is at high risk for an infection. A woman could be at high-risk because of her job, sex partner, and/or lifestyle choices. According to the CDC, the hepatitis B vaccine can be given safely to pregnant women and it does not appear to have any adverse effect on the developing fetus. 
  • If a woman tests positive for hepatitis B, then it is important to protect her newborn from exposure to the virus. 90% of infants exposed to the hepatitis B virus at birth will develop life-long chronic infections.

Protect A Newborn - There is no Second Chance!

Infants born to HBsAg-positive women can be protected against the hepatitis B virus, but only if the hepatitis B blood test results are clearly communicated to the attending physician and delivery room staff.

If the following two medications are given immediately in the delivery room (or within the first 12 hours of life), then there is more than a 95% chance that a newborn will avoid a chronic HBV infection:

Hepatitis B Vaccine - first dose of the vaccine series

Hepatitis B immunoglobulin (HBIG) - 1 or 2 dose

CDC Recommendations for Pregnant Women
Key Points: 

  • The risk of HBV infection in children is not only from perinatal transmission from HBV-infected mothers, but also from close contact with household members and caregivers who have acute or chronic HBV infection.
  • Screen all pregnant women during each pregnancy for HBsAg - repeat during pregnancy if mother is at high-risk for infection.
  • Ensure that all infants born to HBsAg-positive mothers receive timely and appropriate immunoprophylaxis with the hepatitis B vaccine and HBIG.
  • For more information about pregnancy and infant vaccination, visit the CDC homepage

For more information, read Hepatitis B Foundation's Recommendations for Pregnant Women and HBV

The Hepatitis B Foundation convened an expert panel to develop recommendations and easy-to-use flowchart based on existing guidelines to help providers know how to test pregnant women and what actions to take based on the results.
Chronic Hepatitis B in Pregnancy: Screening, Evaluation and Management (Part I and Part II) Published in The Female Patient, April 2012 (vol. 37): pages 22-27 and May 2012 (vol.37): pages 30-34

HBF Algorithm


Page last reviewed March 2014

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