Hepatitis B in Pregnancy and the Newborn

by Jennifer Gibson, MSIV


Background


Hepatitis B is a virus which infects and damages the liver, the organ which cleanses the blood of toxins and waste. Infection with the virus can cause both an acute and a chronic illness. The acute illness usually occurs within a few weeks of infection and consists of fever, nausea, vomiting, abdominal pain, and yellowing of the skin called jaundice. Symptoms of acute hepatitis B usually resolve within a few weeks, and most people who are infected will become immune to the virus without any lingering effects. However, some people who have been infected will become carriers of the virus, which means that they will not feel sick but can still pass the virus to others. A small percentage of those infected will become chronically infected; this group may suffer continued liver damage leading to liver failure or liver cancer. People with chronic hepatitis B infections can also transmit the virus to others.  


The hepatitis B virus is passed from person to person mainly through contact with infected blood; but the virus can also be transferred through contact with infected semen, saliva, and vaginal fluids. Pregnant women who are infected with hepatitis B can transmit the infection to their babies through contact with maternal blood or vaginal secretions during delivery. Babies who are infected with hepatitis B at birth often show no signs of illness immediately but are likely to develop chronic hepatitis later in life. Therefore, every effort should be made to prevent transmission of hepatitis B from an infected mother to her infant.


Prevention


The best way to prevent transmission of hepatitis B from a mother to her baby is for the mother to protect herself from infection. There are several ways to reduce the risk of becoming infected with hepatitis B. One way is to practice “safe sex” by reducing the number of sexual partners and always using a latex condom during intercourse. For mothers who may be injecting drugs, stopping this practice or avoiding the use of shared needles will also reduce their risk of becoming infected. 


Another way to reduce the risk of hepatitis B infection is to be vaccinated against the virus. The hepatitis B vaccine consists of a series of three injections with the second injection given at least 1 month after the first and the third injection given 6 months after the first. The vaccine is considered very safe. Hepatitis B vaccination is recommended for children, intravenous drug users, people with multiple sexual partners, people with kidney or liver disease, people who live with someone infected with hepatitis B, and all health care workers. However, anyone who would like to be immunized against hepatitis B can receive the vaccine. Because the vaccine contains no living virus, pregnant women and breastfeeding mothers can safely receive the vaccine. 


Screening


During pregnancy, all expectant mothers should be screened for hepatitis B. Screening is done by testing blood drawn at the first prenatal visit. At this time, the obstetrician looks for evidence of either an acute hepatitis B infection or carrier status; only those mothers who are currently ill (either with acute or chronic hepatitis) and those mothers who are carriers without illness are at risk for transmitting the virus to their babies. 


Delivery


Both vaginal delivery and Cesarean section are safe methods of delivery for mothers infected with hepatitis B. Due to the risk of transmission of the virus during delivery, all infants of infected mothers receive the first dose of the hepatitis B vaccine as well as hepatitis B immune globulin (HBIG) within 12 hours of delivery. Newborns have undeveloped immune systems, and HBIG contains the specific proteins needed to boost the infant’s ability to fight off a hepatitis B infection acquired during delivery. If the hepatitis B status of a mother is unknown at delivery, the infant should receive the first dose of the hepatitis B vaccine within 12 hours of birth, and the mother’s blood should be tested as soon as possible to determine if the infant needs HBIG.


Newborn Vaccination


The Centers for Disease Control and Prevention (CDC) recommends that all newborns, regardless of maternal viral status, be vaccinated against hepatitis B. Typically, the first injection is given before a newborn is discharged from the hospital; if the first injection is not given during the initial hospital stay, the infant should receive the first shot before 2 months of age. The second and third injections will be given by the infant’s pediatrician at future well-child visits. If the second or third shots are missed, they should be given as soon as possible; there is no need to restart the series. 


The injection administered to infants in the newborn nursery contains only the initial dose of the hepatitis B vaccine. If the infant received this initial dose in the hospital, the second and third doses given by the infant’s pediatrician are often part of a combination vaccine called Pediarix. Pediarix is a single injection which contains the vaccines for hepatitis B, tetanus, diphtheria, pertussis, and polio. Pediarix is typically given at the 2-month, 4-month, and 6-month well-child visits. 


Breastfeeding


Mothers with positive prenatal blood tests can safely breastfeed their babies; there is no evidence that the hepatitis B virus is transferred through breast milk.


5 comments:

mitchdcba said...

Infection with hepatitis B virus is a special problem for pregnant women. Not
only does a pregnant woman face the risks of hepatitis herself, she also can pass it on to others.

1 week pregnant

MyBaby said...

Hepatitis B in Pregnancy and the Newborn may dangerous. Pregnancy is such an incredible gift for woman that must needed some extra care, here I have an information regarding pregnancy and that is tubal reversal which has a solution, tubal reversal
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Marie said...

Hepatitis is an inflammation of the liver. The different types of hepatitis are caused by different things, but they all produce inflammation of the liver. Viral hepatitis refers to several common contagious diseases caused by viruses that attack the liver. The most important types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C. Newly discovered forms of viral hepatitis also include hepatitis D, E, and G. Non-viral forms of hepatitis can be caused by toxic agents (drugs or chemicals), alcohol, or autoimmune processes. Another form of hepatitis is toxic hepatitis. Toxic hepatitis can be caused by viruses or by liver damage due to toxic substances. Toxic hepatitis is a deterioration of the liver cells caused by chemicals, alcohol, drugs, and industrial compounds. Alcohol abuse is a common cause of toxic liver damage.

Hepatitis C is a viral infection of the liver. Some patients have a mild, acute infection that disappears without treatment. When the infection continues for six or more months, it is known as chronic hepatitis C, which can be marked by fatigue and liver function impairment. Those with chronic hepatitis C have an increased risk of later developing cirrhosis or liver cancer.
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zoii said...

No doubt, Hepatitis B is dangerous for mother as well as newborn. Mothers should be careful from any type of infections for newborn as she feels 1 week pregnant signs till birth and after birth also.

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