Perinatal Hepatitis B Prevention Pocket Guide, Pediatric - Minnesota Dept. of Health

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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Perinatal Hepatitis B Prevention Pocket Guide - Pediatric (PDF)

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Management of Pregnant Women
Management of Delivery and Infant
Infants Born to HBsAg-positive Mothers

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
    vaccinated.
  • 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
    unavailable.
  • 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.

After delivery:

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
Result Follow-up needed
Anti-HBs positive
HBsAg-negative
None. Infant is protected.
Anti-HBs negative
HBsAg-negative
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.
Anti-HBs negative
HBsAg-positive
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.

 

Updated Wednesday, March 23, 2016 at 04:17PM