Serologic screening of pregnant women at high risk for transmitting hepatititis B to their newborn

Only by recognition of active HBV illness in the carrier state in pregnant women can perinatal transmission of hepatitis B virus be interrupted with proper medical management of newborns. The current study was undertaken to determine the specific prevalence in pregnant women at high risk of transmitting HBV to their newborns. Blood from these women was screened for hepatitis B surface antigen and, if positive, e antigen was assayed as well. They were also screened for hepatitis B core antibody or hepatitis B surface antibody. A total of 148 pregnant women at high risk of transmitting HBV to their newborns were screened for the carrier state of hepatitis B. Five women (3.4 % of this population) were hepatitis B surface antigen positive. Of these 5, 2 (40%) were e antigen positive. Of the 143 women who were surface antigen negative, 37 (26%) demonstrated past evidence of hepatitis B virus infection. Among the high risk categories, 14.3% of women born in Asia or Africa were hepatitis B carriers and an additional 33% had evidence of past infection. Four percent of drug users were carriers, and 42% demonstrated past exposure. When there was a history of hepatitis, 2% were carriers and an additional 26% showed past infection. Pregnant women at high risk of transmitting HBV to the newborn should be screened to identify potentially infectious women so their infants can be treated appropriately.