Perinatal Transmission

Prgnant woman holding a glass and looking out a window.

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

Scientific Tools and Resources

Interpretation of Hepatitis B Serologic Test Results

One page Summary Table [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.

image of publication
Screening and Referral Algorithm for Hepatitis B Virus (HBV) Infection among Pregnant Women

This is a clinical algorithm for screening and referral of pregnant women who are HBsAg-positive.
Tool [PDF – 1 page]

Thumbnail image of the Clinical Algorithm document

This document describes management of infants born to HBV-infected persons, guidance on interpreting post vaccination serologic testing (PVST) results, and frequently asked questions.

Cover: Management of Infants Born to Women with Hepatitis B Virus Infection for Pediatricians

Ordering Prenatal Hepatitis B Surface Antigen (HBsAg) Tests from Major Commercial Laboratories

All pregnant women should be tested for HBsAg during an early prenatal visit in each pregnancy, and all HBsAg-positive pregnant women should be tested for HBV DNA to guide the use of maternal antiviral therapy during pregnancy.

ARUP Laboratories

Test Option

Test Option

Test Option

Test Name

Test Name

Test Name

Test Code/ID

Test Code/ID

Test Code/ID

CPT Code

CPT Code

CPT Code

Panel

Test Option

Panel

0095044

Test Code/ID

0095044

87340*

CPT Code

87340*

Standalone

Test Option

Standalone

2007573

Test Code/ID

2007573

87340

CPT Code

87340

Labcorp

Test Option

Test Option

Test Option

Test Name

Test Name

Test Name

Test Code/ID

Test Code/ID

Test Code/ID

CPT Code

CPT Code

CPT Code

Panel

Test Option

Panel

202945

Test Code/ID

202945

87340*

CPT Code

87340*

Standalone

Test Option

Standalone

144510

Test Code/ID

144510

87340

CPT Code

87340

Standalone (reflex to DNA)

Test Option

Standalone (reflex to DNA)

144523

Test Code/ID

144523

87340*

CPT Code

87340*

Mayo Medical Laboratories

Test Option

Test Option

Test Option

Test Name

Test Name

Test Name

Test Code/ID

Test Code/ID

Test Code/ID

CPT Code

CPT Code

CPT Code

Panel

Test Option

Panel

PHSP

Test Code/ID

PHSP

87340*

CPT Code

87340*

Standalone

Test Option

Standalone

HBAGP

Test Code/ID

HBAGP

87340

CPT Code

87340

Quest Diagnostics

Test Option

Test Option

Test Option

Test Name

Test Name

Test Name

Test Code/ID

Test Code/ID

Test Code/ID

CPT Code

CPT Code

CPT Code

Panel

Test Option

Panel

20210

Test Code/ID

20210

80055

CPT Code

80055

Standalone

Test Option

Standalone

N/A

Test Name

N/A

N/A

Test Code/ID

N/A

N/A

CPT Code

N/A

N/A=not available

*This CPT code corresponds only to the HBsAg screening component; additional CPT codes might be associated with other component tests.

Notes: CDC recommends healthcare providers use prenatal HBsAg tests (vs. non-specific tests) for pregnant women, which allows for reporting of positive results along with pregnancy status to public health jurisdictions. Refer all HBsAg positive pregnant women to Perinatal Hepatitis B Prevention Program coordinators for case management of mother and infant: https://www.cdc.gov/vaccines/vpd/hepb/hcp/perinatal-contacts.html.

Laboratories reserve the right to add, modify, or stop performing tests at any time – providers should review any test notifications from laboratories for changes.

Policies and Procedures for Prenatal Care and Delivery Hospitals

Delivery Hospitals

Additional Resources

Patient Education Tools

Fact Sheets

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.