Perinatal Transmission
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Hepatitis B virus (HBV) infection in a pregnant woman poses a serious risk to her infant at birth. Without postexposure immunoprophylaxis, approximately 40% of infants born to HBV-infected mothers in the United States will develop chronic HBV infection, approximately one-fourth of whom will eventually die from chronic liver disease.
Perinatal HBV transmission can be prevented by identifying HBV-infected (i.e., Hepatitis B surface antigen [HBsAg]-positive) pregnant women and providing Hepatitis B immune globulin and Hepatitis B vaccine to their infants within 12 hours of birth.
Preventing perinatal HBV transmission is an integral part of the national strategy to eliminate Hepatitis B in the United States. National guidelines call for the following:
- Universal screening of pregnant women for HBsAg during each pregnancy
- Case management of HBsAg-positive mothers and their infants
- Provision of immunoprophylaxis for infants born to infected mothers, including Hepatitis B vaccine and Hepatitis B immune globulin
- Routine vaccination of all infants with the Hepatitis B vaccine series, with the first dose administered at birth
Guidelines and Recommendations
Hepatitis B Vaccination Recommendations for Infants, Children, and
Adolescents
MMWR 2005;54(RR-16)
Corrected Table 4: Hepatitis B Immunization Management of Preterm Infants Weighing <2,000 g, by Maternal Hepatitis B Surface Antigen (HBsAg) Status [PDF - 1 page]
Related Article:
Newborn Hepatitis B Vaccination Coverage Among Children Born January 2003–June
2005 — United States
MMWR 2008;57(30):825-828
Scientific Tools and Resources
Commercial Hepatitis B Serologic Assays
Updated 2012
Interpretation of Hepatitis B Serologic Test Results
This one page tool describes the four most common tests used in hepatitis B serologic testing and provides guidance to interpret different patterns of test results.
Summary Table [PDF- 1 page]
Policies and Procedures for Prenatal Care and Delivery Hospitals
Prenatal Care
Prenatal Care Provider Policies and Procedures [PDF - 1 page]
Algorithm Illustrating Prenatal Care Provider Testing Procedures [PDF - 1 page]
Delivery Hospitals
Delivery Hospital Policies and Procedures to Prevent Perinatal HBV Transmission [PDF - 1 page]
Algorithms illustrating delivery hospital procedures to prevent perinatal HBV transmission when maternal HBsAg test results are available [PDF - 1 page] and unavailable [PDF - 1 page]
Sources for HBIG
HBIG Tables for download [PDF - 2 pages]
Reporting Requirements by State
Maternal Hepatitis B Screening and Reporting Requirements (by State)
New! National Quality, Forum (NQF) Measure 0475 ”Hepatitis B Vaccine Coverage Among All Live Newborn Infants Prior to Hospital or Birthing Facility Discharge”
The National Quality Forum’s (NQF) has declared full endorsement of the Centers for Disease Control and Prevention NQF Perinatal Measure #0475 “Hepatitis B Vaccine Coverage Among All Live Newborn Infants Prior to Hospital or Birthing Facility Discharge.” This measure was 1 of 14 measures formally endorsed, after an extensive peer review process, by NQF Board of Director’s on April 2, 2012. Measure 0475 may be found at: http://www.qualityforum.org/Measures_List.aspx
The October 2008 “time-limited” endorsed measure #0475 “Hepatitis B Vaccine Coverage among All Live Newborn Infants Prior to Hospital or Birthing Facility Discharge” was recently updated for maintenance. Update of the measure to include field testing for feasibility contributed to the full endorsement measure 0475 by the NQF Board of Directors in April 2012. The measure requires each hospital/birthing facility to measure their administration of a dose of hepatitis B vaccine to all infants born in their hospital/birthing facility prior to discharge for a specific time period (e.g. one calendar year). Hospitals are required to assess infants whose parents refused vaccination for exclusion from the coverage estimate. Please find below documents outlining the specifications of the measure and an appendix of the ICD-9 codes that correspond to the ICD-10 codes pending complete implementation of the new codes.
NQF #0475 [PDF - 4 pages] AppendixA [PDF - 1 page]
Public Health Department Perinatal Hepatitis B Coordinator List
Contact information for state, territorial, and local coordinators who work in the health department and provide case management to prevent perinatal transmission of HBV infection
Perinatal Hepatitis B Prevention Coordinator List
Childhood Immunization Schedule
http://www.cdc.gov/vaccines/recs/schedules/default.htm#child
Case Management
Patient Education Tools
Fact Sheets
| Title | English | Other Languages | ||
|---|---|---|---|---|
| Color | B/W | Color | B/W | |
| Hepatitis B and Your Baby | Spanish | Spanish | ||
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)Educational Slide Presentations
This slide presentation is audio-visual educational tool that describes the importance of getting babies vaccinated against hepatitis B if a mother has hepatitis B infection. It can be played from the website, or downloaded and printed to be used as a flip chart. The 13 page slide presentation uses plan and simple language. Audio is available in:
- Mandarin Chinese
- Hmong
- Korean
- Vietnamese
- Tagalog/Taglish (written only)
- English
Hepatitis B and Your Healthy Baby
This slide presentation is a 24 page illustrated educational tool for pregnant women who have Hepatitis B. The slide presentation explains the importance of getting babies vaccinated against Hepatitis B to prevent transmission of the disease. It is available in a written format only, but can be downloaded and printed to be used as a flip chart. The text is in easy to understand English, and also available in Spanish.
Specific Sites and Tools
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Program Resources
Hepatitis B Vaccine at BirthVariety of materials on the birth dose of Hepatitis B vaccine -
CDC Resources
State Immunization Laws for Health Care Workers and Patients
Maternal Hepatitis B screening and reporting requirements (by state)Perinatal Hepatitis B Prevention Coordinators Program Page
A resource center for CDC-funded perinatal Hepatitis B prevention programs
Outside CDC (
Other
Federal sites
State/Local sites
