Since December 2000, HBsAG positive status during pregnancy has been a required reportable condition in Washington State.
Healthcare providers are legally required to report all acute hepatitis B and HBsAg positive pregnant women to their local
health department within 3 days of the receipt of laboratory serology reports, chronic infections are to be reported monthly
(WAC 246-101).
Once the report is received, the Perinatal Hepatitis B Program coordinator enrolls the pregnant woman in a case management
tracking program to provide her with additional information on hepatitis B prevention and recommendations for her infant and
household contacts.
CDC estimates that only approximately half of expected births to HBsAg-positive mothers are identified for case management.
In addition, errors in management of infants born to HBsAg-positive mothers and infants born to mothers with unknown HBsAg
status have kept many of these infants from receiving appropriate immunoprophylaxis to prevent HBV infection. (A link for
standing orders in labor and delivery is listed under resources.)
Screening during pregnancy:
All pregnant women should be screened for HBsAg during each pregnancy.
Women who test negative for HBsAg early in their pregnancy but who are at increased risk for hepatitis B should be
screened again at the time of delivery.
It is the responsibility of the provider to assure that the client's hospital for delivery is informed of an HBsAg
positive mother prior to delivery so appropriate treatment is provided for the infant.
Vaccination of exposed infant:
The pregnant woman will be contacted and enrolled in the program to assure that her high risk infant receives the first
dose of hepatitis B vaccine and HBIG within 12 hours of birth.
HBIG may be given up to 7 days after birth, but the effectiveness diminishes the longer after exposure that it is
initiated.
Two additional doses of hepatitis B vaccine, at 1 month of age and six months of age are needed.
These infants should also be screened at 9-15 months of age (about 3 to 9 months after the third dose of hepatitis
B vaccine) for HBsAg and anti-HBs.
Since December 2000, HBsAG positive status during pregnancy has been a required reportable condition in Washington State.
Healthcare providers are legally required to report all acute hepatitis B and HBsAg positive pregnant women to their local
health department within 3 days of the receipt of laboratory serology reports, chronic infections are to be reported monthly
(WAC 246-101).