Prevention of Perinatal Hepatitis B Virus Transmission in an Obstetric/Infant Population

Abstract

Study Design: This retrospective study reviewed the screening practice and seroprevalence of hepatitis B surface antigen (HBsAg) among all mothers with live births at a teaching hospital in Montreal between November 1, 1990 and April 30, 1991.Results: Most women (94%) were screened prenatally and 5.2% postnatally. Screening status could not be determined for 0.8% of women. One‐quarter of all postnatal screening results were available only at 48 h or more postdelivery. No infants born to women with postnatal screening or to women with unknown screening status were immunized expectantly. The maternal seroprevalence was 1.08% (95% confidence interval from 0.6, 1.4). All 22 infants born to HBsAg‐positive mothers had received hepatitis B immune globulin within 12 h of birth and the first dose of hepatitis B vaccine within 24 h. Follow‐up of infants revealed that only 50% had received the second and third doses according to the recommended protocol, with 83% completing the immunization series.Conclusion: These results indicate that a program of prenatal HBsAg screening and neonatal prophylaxis against hepatitis B can be successfully instituted in a high volume obstetric hospital, and that better monitoring of infants is required to ensure completion of vaccination.