Perinatal Transmission
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
- Screening all HBsAg-positive pregnant women for HBV DNA to guide the use of maternal antiviral therapy during pregnancy. AASLD suggests maternal antiviral therapy when HBV DNA is >200,000 IU/mL
- 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 within 12 hours of birth
- Routine vaccination of all infants with the hepatitis B vaccine series, with the first dose administered within 24 hours of birth
Guidelines and Recommendations
Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices
MMWR 2018; 67 (RR 1);1–31
Scientific Tools and Resources
Interpretation of Hepatitis B Serologic Test Results
One page Summary Table pdf icon[PDF- 1 page] describes the four most common tests used in hepatitis B serologic testing and provides guidance to interpret different patterns of test results.
Screening Pregnant Women for Hepatitis B Virus (HBV) Infection and Screening and Referral Algorithm for hepatitis B Virus (HBV) Infection among Pregnant Women
Page one lists the offered prenatal hepatitis B surface antigen (HBsAg) tests at four major commercial laboratories that indicate pregnancy status on reportable positive HBsAg results. Page two provides a clinical algorithm for screening and referral of pregnant women who are HBsAg-positive.
Tool pdf icon[PDF- 2 pages]
Policies and Procedures for Prenatal Care and Delivery Hospitals
Delivery Hospitals
Algorithms illustrating delivery hospital procedures to prevent perinatal HBV transmission when maternal HBsAg test results are available pdf icon[PDF – 1 page] and unavailable pdf icon[PDF – 555 KB]
Additional Resources
- Perinatal Hepatitis B Prevention 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
- Childhood Immunization Schedule
- Laboratory Reporting of Pregnancy Status for hepatitis B-positive Women
- PVST Panels for Infants Born to HBV-infected Women and information on an effort to improve PVST among this group by recruiting laboratories to offer hepatitis B PVST panels for infants.
- Menu of State Health care Facility Hepatitis B Vaccination Laws from the CDC Public Health Law Program
- Give birth to the end of Hep Bexternal icon from Immunization Action Coalition
Patient Education Tools
Fact Sheets
| Title | English | Other Languages |
|---|---|---|
| When a Pregnant Woman Has Hepatitis B | PDFpdf icon | Spanish (Español)pdf icon French (Français)pdf icon Russian (Русский)pdf icon Burmese ( 
Chinese (中文)pdf icon 
)pdf icon  |
| Hepatitis B and Your Baby | PDFpdf icon | Spanishpdf icon |
| Vaccinate Your Baby Against Hepatitis B Infographic | PDFpdf icon | Spanishpdf icon |
Educational Slide Presentations
Hepatitis B and a Healthy Baby
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. The 13 page slide set uses simple language and has audio in: Mandarin Chinese, Hmong, Korean, and Vietnamese, as well as English. Tagalog, in the form of Taglish, is available in a written format only.
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. The text is in easy to understand English, and is also available in Spanish.