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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 imperative for pregnant women to 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 make arrangements to have the proper medications in the delivery room to prevent your baby from being infected. 

ALL pregnant women should be tested for hepatitis B. Testing is especially important for women who fall into high-risk groups such as health care workers, women from ethnic communities 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, then your newborn must be given two shots immediately in the delivery room:

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

* Note: HBIG is recommended by CDC. HBIG may not be available in all countries.

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

Although the CDC states that the medications can be given within the first 12 hours of life, 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 administer these medications immediately in the delivery room to avoid any delays or mistakes.

If you test positive for hepatitis B, your doctor should also test for the hepatitis B e-antigen (HBeAg), and if positive, you should have a viral load blood test. In some cases, the laboratory test results may show a very high viral load. In these cases, your physician may recommend an oral antiviral drug in the third trimester to reduce the risk of infecting your newborn at birth. 

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

You can also find the simple, updated (2020) flowchart here:  Prenatal-Resources-7-17-21.pdf