Prevalence and Risk Factors of Hepatitis B Virus among Pregnant Women in Jazan Region- Kingdom of Saudi Arabia

Background: Hepatitis B virus is one of the major etiological agents for parenterally acquired hepatitis. Viral hepatitis during pregnancy is associated with high risk of maternal complications. This study was conducted to determine the prevalence of HBV infection in pregnant women, and to find out its associated risk factors in Jazan region south KSA. Patients & Methods: A random sample of 537 pregnant females who attended Jazan general hospital and randomly selected primary health care centers in Jazan region - before 38 weeks of gestation - constituted the target population of the present study. All women were screened for HBsAgd by using HBsAg Rapid Test Device (ACON). Results: The overall prevalence of HBV virus among the women was found to be 4.1% (95% CI: 2.7 - 6.1). The prevalence of HBV according to age showed that women less than 20 years are free of HBV, whereas for other age groups HBV prevalence is found to increase with increase in age. Regarding the associated risk factors, women with history of hospitalization, and jaundices showed a significant association with anti- HBV seropositive. Dental histories, blood transfusion and history of surgery did not prove significant association with HBV. Conclusion: Prevalence of Hepatitis B virus infection in pregnant ladies was 4.1%. Past history of hospitalization and jaundices are important risk factors for transmission of infection. The study suggests expansion of the Hepatitis B vaccination program to reduce the risk of HBV among pregnant women. Hepatitis B is caused by hepatitis B virus (HBV) which is an envelope virus with double strand DNA that related to hepadnavirus. HBV is found in highest concentrations in blood and in lower concentrations in other body fluids (e.g., semen, vaginal secretions, and wound exudates). It estimated that about 5% of world populations are chronic carriers and nearly 25% of them develop serious complications as chronic hepatitis, liver cirrhosis and hepatocellular cell carcinoma, which result in more than one million death every year (1). Hepatitis B virus (HBV) infection is a major public health problem in the Arab Countries. The majority of the countries in the Middle East have intermediate (2 to 5%) endemicity of HBV infection (2). Studies in Saudi Arabia indicated that the prevalence of Hepatitis B surface antigen (HBsAg) ranges from 7.4 to 17% denoting high endemicity. (3). The HBV is a major cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. It ranks as an important pathogen throughout the world(4). Transmission occurs mainly from a mother to child at time of parturition, as well as person-to-person (horizontal) transmission among children < 5 years of age. (5) Even when not infected during the perinatal period, children of HBV-infected mothers remain at a high risk of acquiring HBV infection by horizontal transmission during the first 5 years of life. (6) Viral hepatitis during pregnancy is associated with high risk of maternal complications, has a high rate of vertical transmission causing fetal and neonatal hepatitis and it has been reported as a leading cause of maternal mortality in developing countries (7-9). Previous studies showed that the prevalence of HBsAg among Saudi pregnant females ranged from 3.9 to 12.7%. (9-12) The aim of the present study was to determine the prevalence and risk and its related factors of HBV infection among pregnant women in Jazan region - Saudi Arabia . 2. Material and Methods: This study was part of a large cross-sectional survey conducted on volunteer blood donors, and attendants of GI , Premarital screening clinics and Antenatal Clinics ( in randomly selected PHCCs and General Hospitals) in Jazan Region, Kingdom of Saudi Arabia (KSA). All pregnant females who attended the antenatal clinic - before 38 weeks of gestation - constituted the subjects of the present study. Serology screening for HBsAg, Hepatitis B core antigen (HBcAb), and Hepatitis B