Perinatal Hepatitis B

One way hepatitis B virus (HBV) is transmitted is from a pregnant person to an infant during birth (called perinatal transmission). When a pregnant person has hepatitis B virus infection, it can pose a serious risk to their infant at birth. Infants with hepatitis B virus infection have about a 90% chance of developing a chronic hepatitis B virus infection if they do not have timely protection with a hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) shortly after birth. As a postexposure measure for infants born to a hepatitis B surface antigen-positive birth parent, hepatitis B vaccine without hepatitis B immunoglobulin is 75% effective at preventing perinatal hepatitis B virus transmission, but when combined with hepatitis B immunoglobulin, the effectiveness is 94%.

In the 57 counties outside New York City, the New York State Department of Health implements a Perinatal Hepatitis B Prevention Program (PHBPP) consistent with guidance from the Centers for Disease Control and Prevention and New York State law and regulations.

Perinatal Hepatitis B Prevention Program goals:

• Screen every person during every pregnancy for hepatitis B surface antigen (HBsAg) and record the test result prominently in the pregnant person’s and infant’s hospital medical record.
• Provide case management for infants born to birthing persons who have hepatitis B virus infection and persons with unknown hepatitis B virus status to assure the completion of hepatitis B immunoglobulin, hepatitis B vaccine series, and post-vaccination serologic testing.
• Ensure all birthing hospitals give postexposure immunoprophylaxis appropriately to infants born to persons infected with hepatitis B virus and persons with unknown hepatitis B virus status.
• Promote the universal birth dose of hepatitis B vaccine, which provides a safety net for the prevention of perinatal and early childhood infection, facilitates implementation of universal hepatitis B vaccination recommendation, and prevents infection in adolescents and adults.

To help ensure that these goals are met, NYS Public Health Law 2500-e and Title 10 of the Official Compilation of Codes, Rules and Regulations Subpart 69-3 include several mandates and describes the responsibilities of prenatal health care providers, delivery hospitals, clinical laboratories, pediatricians and family practice physicians, parents, and the state and local health departments.