Perinatal Hepatitis B Prevention Pocket GuideA pocket guide to assist healthcare providers with recommended strategies to prevent perinatal transmission of hepatitis B including the vaccine schedule for infants born to HBsAg positive mothers.
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Perinatal Hepatitis B Prevention Pocket Guide (PDF: 40KB/2 pages)
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Prenatal HBsAg Testing
- Test ALL pregnant women within first trimester of EACH pregnancy, even if tested before or had hepatitis B vaccines.
- Send copy of lab report with the HBsAg-positive results to
hospital of delivery and the infant’s healthcare provider.
- Report to MDH all HBsAg-positive women within one working
day of knowledge of the pregnancy.
- Refer for or provide HBsAg-positive women counseling and
medical management. Give the following information:
- Modes of hepatitis transmission.
- Perinatal concerns (i.e. HBsAg-positive mothers may breastfeed, treatment of newborns for exposure to hepatitis B).
- Prevention of HBV to contacts, include vaccine prophylaxis for infant(s) and testing and/or hepatitis B vaccination for household, sexual, and needle-sharing contacts.
- Substance abuse treatment and/or mental healthcare if appropriate.
- Medical evaluation and possible treatment of chronic hepatitis B.
At admission for delivery:
- Review HBsAg status of all pregnant women. Perform HBsAg
testing as soon as possible on women who:
- do not have a documented HBsAg test result,
- were at risk for HBV infection during pregnancy, or
- had clinical hepatitis since previous testing.
- Retest HBsAg-negative
women (at time of hospital delivery) with high-risk behaviors for infection:
- Injection-drug use,
- More than one sex partner in 6 months,
- HBsAg-positive sexual partner,
- Evaluation or treatment for sexually transmitted disease (STD),
- Exhibits clinical hepatitis symptoms.
- Place copy of maternal HBsAg results on labor/delivery record, infant’s delivery summary, and nursery medical record.
ALL infants should receive:
HBsAg status is:
Also give infant:
Hep B vaccine within 12 hours of birth
|HBIG within 12 hours of birth|
|No HBIG needed|
|Give HBIG if test positive
Must be given within 7 days of birth
- For HBsAg-positive mothers and mothers
whose HBsAg status is unknown at
time of discharge
- Fax “Hospital Report Form” to MDH within 1 working day of infant’s birth.
- Alert infant’s pediatric provider.
- Record date and time vaccines were given on infant’s record.
- Completion of hep B vaccine series at 1-2 months and 6 months of age (using monovalent vaccine).
- If using a combination hep B vaccine (e.g. Hib-hep B or DTaP-IPV-hep B), final dose should NOT be administered before age 24 weeks (164 days).
- Administration of 4 doses of hep B vaccine is permissible when giving combination vaccines after the birth dose.
- Report all vaccine dates to local and/or state health departments.
- Perform post-vaccination
serology at 12 months of age. (No earlier than 9 months of age.)
- Test for both HBsAg and anti-HBs.
- Report test results to local and/or state health department.
|Interpretation of Serology Results|
|None. Infant is protected.
|No response. Infant is susceptible to infection. Repeat 3 doses of hep B vaccine series as soon as possible. Schedule of 0,1,4 months. Recheck serology 4-6 weeks after last dose. Monovalent hepatitis B vaccine must be used for second series.|
|Infant infected with hepatitis B. Needs regular check-ups and liver function tests.|
|Remember to report HBsAg-positive test results to local and/or state health department.|