Perinatal Hepatitis B Prevention Pocket Guide - Pediatric
Pocket guide to assist pediatric health care providers with recommended strategies to prevent perinatal transmission of hepatitis B.
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Management of Pregnant Women
Prenatal HBsAg Testing
- Test ALL pregnant women during an early prenatal visit in EACH pregnancy, even if tested before or previously
- Send copy of lab report with the HBsAg-positive results to the delivery hospital and the infant’s health care provider.
- Report to MDH all HBsAg-positive women within one
working day of knowledge of the pregnancy.
Management of Delivery and Infant
At admission for delivery:
- Review HBsAg status of all pregnant women. Perform STAT
testing if HBsAg result for the current pregnancy is
- Retest HBsAg-negative women (at time of hospital delivery)
if high-risk for infection:
- Injection-drug use
- More than one sex partner in 6 months
- HBsAg-positive sexual partner
- Evaluated/treated for STD
- Exhibits clinical hepatitis symptoms
- Place copy of maternal HBsAg results in labor/delivery record, infant’s delivery summary, and nursery medical record.
|ALL infants should receive:||If mother's HBsAg status is:||Also give infant:|
|Hep B vaccine within 12 hours of birth||Positive||HBIG within 12 hours of birth|
|Negative||No HBIG needed|
|Unknown (at discharge)||Give HBIG if test positive (must be given within 7 days of birth)|
- Preterm infants weighing less than 2,000g:
- Born to HBsAg-positive mothers: give hep B vaccine and HBIG within 12 hours of birth.
- Born to HBsAg-negative mothers: give first dose of hep B vaccine at one month of age.
- Born to mothers whose HBsAg status is unknown: give hep B vaccine and HBIG within 12 hours of birth.
Infants Born to HBsAg-positive Mothers
- Report to MDH all infants born to HBsAg-positive women within 24 hours of birth.
- Completion of hepatitis B vaccine series at 1-2 months and
6 months of age.
- Administration of 4 doses of hepatitis B vaccine is permissible when giving combination vaccines after the birth dose.
- Perform post-vaccination serology at 9-12 months.
- Test for both HBsAg and anti-HBs.
- Report all vaccine dates and serology results to local and/or state health department.
|Interpretation of Serology Results|
|None. Infant is protected.|
|No response. Infant is susceptible to infection. Repeat hep B monovalent vaccine series using an accelerated schedule of 0, 1, and 4 months. Recheck serology 1-2 months after third dose.|
|Infant is infected with hepatitis B. Consult with liver specialist for follow-up and ongoing care.|
|Remember to report HBsAg-positive test results to MDH.|