I am currently pregnant, and I have chronic hepatitis B. What should I do to protect my baby?
Pregnant people who have hepatitis B can transmit the virus to their newborns during delivery (due to the blood exchanged during the childbirth process). Many of these babies will become chronically infected, which increases their risk of serious liver disease later in life. However, we can prevent hepatitis B transmission from mother to baby! There are a few simple steps you and your doctor can take.
Your newborn must be given two shots in the delivery room - the first dose of hepatitis B vaccine (5 mcg dose) and one dose of hepatitis B immune globulin (HBIG, 0.5 mL dose)*. These two shots must be given at separate injection sites, i.e. different limbs. If these two medications are given correctly within the first 12 hours of life, a newborn has a 95% chance of being protected against a lifelong hepatitis B infection. The infant will need additional doses of hepatitis B vaccine at one and six months of age to provide complete protection.
* Note: HBIG is recommended by U.S. CDC. HBIG is not recommended by World Health Organization (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!
Another important step to reduce the risk of transmitting the infection to your baby, is to determine whether the viral load (HBV DNA) is high in your blood. If the viral load is high, it is recommended that you take antivirals during the third trimester of pregnancy, to get the virus under control, and reduce the risk of transmission to your baby. Assessing the viral load is best done through an HBV DNA test, however this test is not always available, and often is expensive. The World Health Organization (WHO) recommends that all pregnant women get tested for HBeAg. If HBeAg is positive, it is recommended to receive antiviral therapy during the final three months of pregnancy (third trimester).
(1) Ask your doctor to test you for HBeAg or HBV DNA (hepatitis B viral load test if it is available) to determine if treatment with an antiviral is needed during the last trimester of your pregnancy.
(2) Make sure you have chosen a specific health facility to deliver your baby. Inform the healthcare team there that you will need the hepatitis B vaccine ready for your babies in the delivery room (or as soon as possible but within the first 12 hours of birth).
(3) When it is time for the baby to be delivered, make sure to go to that health facility for your delivery.
Children who receive hepatitis B vaccine and HBIG at birth should complete the 3-part vaccine series and should be tested at 9-15 months of age, to make sure that the vaccine worked and that they are not infected and have protection against hepatitis B. Testing before 9 months of age can be inaccurate.
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Page updated 02/09/2022