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CDC Recommendations for Pregnant Women

The Hepatitis B Foundation has prepared the following summary of the CDC recommendations for pregnant women. Read the web linkFull Report.

Pregnant Women and State HBsAg Requirements

  • Currently, only 19 states require HBsAg screening of pregnant women in the U.S.
  • It is recommended that obstetricians and family doctors routinely screen all pregnant women for HBsAg during each pregnancy, regardless of the presence or absence of risk factors and regardless of history of vaccination.

Screen All Pregnant Women for HBsAg

  • Identifies infants requiring immunoprophylaxis soon after birth to prevent perinatal HBV infection.
  • Identifies household contacts needing vaccination.
  • Allows medical follow-up of women and other contacts with chronic HBV infection.

Hepatitis B Immunization at Birth

  • Eliminates the possibility of missed immunoprophylaxis in infants born to mothers who are HBsAg-positive.
  • Ensures that infants born of mothers whose HBsAg status is unknown at delivery receive appropriate immunoprophylaxis.
  • Reduces the risk of early childhood infection.

How to Implement Routine Hepatitis B Vaccination at Birth

  • Give all infants a birth dose of hepatitis B vaccine in the hospital
    • Treat infants born to HBsAg-positive mothers within 12 hours of birth.
    • Hepatitis B vaccine (give dosage for babies born to infected mothers; only monovalent hepatitis B vaccine can be used for the birth dose.).
    • Give the first dose of vaccine with HBIG, but at a different site.
    • Give the preferred vaccination schedule at 0, 1-2, 6 months with testing for HBsAg and antibody to HBsAg (anti-HBs) at aged 9-15 months.
  • Transmit screening and vaccination records
    • Follow-up HBsAg-positive mothers and treatment of infants must be ensured.
    • Transfer of HBsAg screening information between prenatal care provider and delivery services.
    • Transfer of infant vaccination record between hospital nursery and pediatric services.
  • Management of infants born to women without prenatal HBsAg screening
    • Draw mother's blood for HBsAg testing on admission.
    • Give hepatitis B vaccine to infant within 12 hours of birth.
    • Give HBIG within 7 days of birth if maternal test results are positive.
    • Complete infant vaccination series at 0, 1-2, 6 months.
    • Assure following HBsAg and anti-HBs testing of infant at aged 9-15 months.

Summary Points

  • The risk of HBV infection in children is not only from perinatal transmission from HBV-infected mothers, but with 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 practices high risk behaviors.

  • Ensure that all infants born to HBsAg-positive mothers receive timely and appropriate immunoprophylaxis with HBIG and hepatitis B vaccine.

Excerpted from the Centers for Disease Control web linkBack to Basics: The Challenge of Reinstating Hepatitis B Vaccination at Birth.

 

Page last modified October 21, 2009

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