Hepatitis B in pregnancy: Specific issues and considerations

Abstract

Chronic hepatitis B affects over 350 million people worldwide. Vertical transmission is known to be the leading cause of infection and perinatal infection is associated with a very high rate of chronicity (up to 90%). Up to 40% of chronically infected individuals will die prematurely from complications such as acute liver failure, cirrhosis and hepatocellular cancer. Addressing perinatal transmission through the use of immunoprophylaxis can help contain the spread of HBV. Pregnant mothers with chronic hepatitis B have unique challenges and require specialised management during and after pregnancy. This review will look at the screening of pregnant women for hepatitis B, passive and active immunoprophylaxis, mechanisms of perinatal viral transmission and therapeutic considerations in pregnancy including possible teratogenicity and efficacy of medication. Other issues such as the mode of delivery and breastfeeding will be covered. © 2012 Ho V, et al.