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Hepatitis B in Pregnancy and Prevention of Perinatal Hepatitis B

The resources presented here offer health care professionals current information about reporting and management of hepatitis B infection in pregnancy and prevention of perinatal transmission of hepatitis B to newborns.

Hepatitis B Birth Dose Coverage by NYC Facility:

Reporting Hepatitis B in Pregnancy

NYC Providers who identify pregnant people infected with hepatitis B virus are required by New York State law, as well as NYC Health Code, to report such cases to the NYC Health Department.

Reports may be submitted electronically or via paper reports. Additional details on reporting via either method are provided below:

  • Electronic Reporting – Providers can report cases of Hepatitis B in pregnancy on-line by filling out an electronic URF (eURF) for Perinatal Hepatitis B. This is the preferred method. For instructions on how to complete an eURF click here.
  • Paper Reporting – If unable to report on line, providers may report cases of hepatitis B infection in pregnancy via the IMM-5 reporting form  (PDF).

Identification and Management of Hepatitis B Infection in Pregnancy

  • New York State Public Health Law 2500-e, mandates that all pregnant people be screened for hepatitis B surface antigen (HBsAg) during pregnancy (preferably in the 1st trimester)
  • When ordering hepatitis B virus testing for pregnant people, prenatal care providers should order the test as part of a prenatal panel when possible or indicate pregnancy status or include a pregnancy related diagnostic code on the lab requisition. These measures will prompt the laboratory to report positive hepatitus B laboratory results in pregnant people to the health department. 
  • Prenatal care providers should include the hepatitis B status of pregnant people in the prenatal chart and provide a copy of the original HBsAg laboratory report along with records sent to the expected hospital of delivery
  • HBsAg-negative women who are at risk for HBV infection (non-immune, multiple sexual partners or injection drug use) during pregnancy should be offered hepatitis B vaccination and retested for HBsAg at the time of delivery
  • HBsAg-positive patients should be referred to a specialist for evaluation of their chronic hepatitis B infection
  • Sexual and household contacts of HBsAg-positive patients should be screened for hepatitis B and vaccinated if susceptible.

Prevention of Perinatal Transmission of Hepatitis B Infection

  • All infants born to HBsAg-positive people should be administered hepatitis B immune globulin (HBIG) and the 1st dose of hepatitis B vaccine within 12 hours of birth, these infants should receive their 2nd dose of hepatitis B vaccine at 1 month of age
    • Infants born to people with unknown HBsAg status should be administered the 1st dose of hepatitis B vaccine (without HBIG) if results of HBsAg testing are not available within 12 hours of birth. If the result is HBsAg positive, HBIG should be administered to the newborn as soon as possible and no later than age 7 days.
    • Standard of care is that all other infants should receive their first dose of hepatitis B vaccine no later 24 hours after delivery.
  • Infants born to HBsAg-positive people should complete the hepatitis B vaccination series following the recommended routine childhood immunization schedule.
  • All children born to hepatitis B infected people should be tested for both HBsAg and hepatitis B surface antibody (anti-HBs) at 9 to 12 months of age. 

Additional Resources

Hepatitis B Vaccine Birth Dose Information for Hospitals

Hepatitis B Vaccine Patient – Slide-sets

  • Hepatitis B and a Healthy Baby (two slide-sets for hepatitis B infected pregnant women)

Hepatitis B Patient Handouts

Prevention of Perinatal Hepatitis B for Healthcare Professionals

General

For Prenatal Care Providers

For Laboratories and Infection Control

For Delivery Facilities

For Pediatricians

More Information