Planned Out-of-Hospital Birth as a Risk Factor for Nonreceipt of Hepatitis B Immunization

Area of Science:

• Neonatal care
• Vaccinology
• Public health

Background:

• Hepatitis B vaccine (HBV) at birth prevents perinatal transmission.
• Many newborns do not receive the HBV birth dose.
• Planned out-of-hospital births are increasing.

Purpose of the Study:

• To determine if planned out-of-hospital birth location is associated with nonreceipt of the HBV birth dose.

Main Methods:

• Retrospective cohort study (2007-2019) using Colorado birth registry data.
• Chi-squared analyses for demographic comparisons.
• Logistic regression to assess birth location's association with HBV nonreceipt.

Main Results:

• 1.5% of birth center and 0.1% of home births received HBV vs. 76.3% of hospital births.
• Out-of-hospital births significantly increased odds of HBV nonreceipt (aORs 173-502).
• Older maternal age, White/non-Hispanic ethnicity, higher income, and insurance status also associated with nonreceipt.

Conclusions:

• Planned out-of-hospital birth is a significant risk factor for missing the HBV birth dose.
• Increasing prevalence of out-of-hospital births necessitates targeted interventions.
• Policies and education are warranted to improve HBV birth dose coverage.