Intrapartum hepatitis B screening in a low-risk population

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Public Health

Background:

• Hepatitis B virus (HBV) infection poses risks during pregnancy and childbirth.
• Timely administration of hepatitis B immune globulin (HBIG) to newborns is crucial for preventing HBV transmission.
• Intrapartum screening for hepatitis B surface antigen (HBsAg) can facilitate prompt HBIG delivery.

Purpose of the Study:

• To evaluate the prevalence of HBsAg among laboring patients.
• To assess the feasibility and impact of intrapartum HBsAg screening on newborn HBIG administration.
• To determine the cost-effectiveness of intrapartum HBsAg screening.

Main Methods:

• A prospective study involving intrapartum HBsAg testing of all laboring patients.
• Data collection on patient demographics, HBsAg status, and risk factors.
• Tracking the time interval between birth and HBIG administration for newborns.

Main Results:

• A total of 5580 patients were tested, with an overall HBsAg prevalence of 0.14%.
• Prevalence was higher in public patients (0.3%) compared to private patients (0.08%).
• The average time from birth to HBIG administration was 13.3 hours, with some newborns receiving it beyond the recommended 12-hour window.

Conclusions:

• Intrapartum HBsAg screening is a viable strategy for identifying HBV-infected mothers.
• The screening supports timely HBIG administration to newborns, aligning with ACOG recommendations.
• While effective, the screening process may result in some newborns exceeding the CDC's recommended 12-hour interval for HBIG.