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Published on: May 10, 2022

Caring for pregnant women and newborns with hepatitis B or C

Nguyet-Cam Vu Lam1, Patricia B Gotsch, Robert C Langan

  • 1St. Luke's Family Medicine Residency, Bethlehem, PA 18017, USA. lamc@slhn.org

American Family Physician
|December 3, 2010
PubMed

Insights

Hepatitis B screening and prophylaxis for pregnant women significantly reduce infant infection. Early intervention for hepatitis B prevents chronic illness, while hepatitis C prevention remains challenging.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Maternal-Fetal Medicine

Background:

  • Perinatal transmission of hepatitis B virus (HBV) poses a significant risk for chronic infection in infants, leading to serious long-term health consequences.
  • Hepatitis C virus (HCV) also transmits perinatally, though with lower rates and no current effective preventive measures.

Purpose of the Study:

  • To outline diagnostic and treatment strategies for family physicians managing pregnant patients with HBV or HCV.
  • To emphasize the importance of early identification and prophylaxis in preventing perinatal HBV transmission.

Main Methods:

  • Routine screening of all pregnant women for hepatitis B during prenatal evaluations.
  • Re-evaluation for pregnant women with risk factors during labor.
  • Administration of hepatitis B immune globulin and vaccination to infants of HBsAg-positive mothers within 12 hours of birth.
  • Hepatitis B vaccination for all infants before hospital discharge.
  • Diagnosis of perinatal HCV by detecting HCV RNA or antibodies at specific ages.

Main Results:

  • Early identification and prophylaxis are 85-95% effective in preventing perinatal HBV acquisition.
  • Infants born with perinatally acquired HBV have a 90% chance of becoming chronic carriers.
  • Perinatal HCV transmission rates are less than 10%.

Conclusions:

  • Comprehensive screening and timely prophylaxis are crucial for preventing perinatal HBV transmission and its severe sequelae.
  • Effective measures for preventing perinatal HCV transmission are lacking, necessitating careful diagnosis in infants.
  • Interdisciplinary communication and standing hospital orders can optimize preventive strategies.

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