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Pregnancy and Hepatitis B

iStock 000024903508 LargeBabies born to a mother with hepatitis B have a greater than 90% chance of developing chronic hepatitis B if they are not properly treated at birth. It is very important that pregnant people know their hepatitis B status in order to prevent passing the virus on to their newborn baby during delivery. If your doctor is aware that you have hepatitis B, he or she can ensure hep B transmission to your baby is prevented by taking the right steps based on blood tests results and to make arrangements to have the proper medications in the delivery room to prevent your baby from being infected. 

ALL pregnant people should be tested for hepatitis B. Testing is especially important for people who fall into high-risk groups such as health care workers, people from ethnic communities or countries where hepatitis B is common, spouses or partners living with an infected person, etc. If you are pregnant, be sure your doctor tests you for hepatitis B before your baby is born, ideally as early as possible during the first trimester.

If you test positive for hepatitis B infection, then your newborn must be given proper prevention immediately in the delivery room, clinic or bedside:

  • first dose (called "birth dose") of the hepatitis B vaccine
  • one dose of the Hepatitis B Immune Globulin (HBIG).*

* Note: HBIG is recommended by U.S. CDC. HBIG is not recommended by WHO and may not be available in all countries. What is most important is to make sure the hepatitis B vaccine birth dose is given as soon as possible!

If these two medications are given correctly, a newborn born to a person with hepatitis B has more than a 90% chance of being protected from a hepatitis B infection. You must make sure your baby receives the remaining shots of the vaccine series according to schedule to ensure complete protection.

Although the U.S. CDC states that the medications can be given within the first 12 hours of life and the WHO states vaccine birth dose can be given within 24 hours, there is no second chance to protect an infant once this window of opportunity is missed. Therefore, the Hepatitis B Foundation strongly recommends that health care professionals properly administer the birth dose of the hepatitis B vaccine immediately in the delivery room to avoid any delays or mistakes.

If you test positive for hepatitis B infection while pregnant, your doctor also should do a hepatitis B viral load blood test (HBV DNA) during your pregnancy. In some cases, the laboratory test results may show a very high viral load. In these cases, your physician may recommend that you take an oral antiviral drug in your third trimester to reduce the risk of infecting your newborn at birth. If the hepatitis B viral load test is not available, WHO recommends that pregnant women are tested for the hepatitis B e-antigen (HBeAg), and if positive, an antiviral is recommended during the last trimester. Regardless of viral load levels or HBeAg status, the hepatitis B vaccine birth dose and completion of the vaccine series is essential to protect your infant from infection with the hepatitis B virus. 

Additional Resource Links: 

U.S.: Centers for Disease Control and Prevention: Viral Hepatitis, Perinatal Transmission (2022)

EU/EEA: Antenatal Screening for HIV, Hepatitis B, Syphilis and Rubella Susceptibility in the EU/EEA (2016)

Globally: WHO Prevention of Mother-To-Child Transmission of Hepatitis B Virus: Guidelines on Antiviral Prophylaxis in Pregnancy (2020)

Page updated September 2020.