Hepatitis B and Pregnancy - NYC Health

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Infectious Diseases

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Children and Adolescents

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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:

2021 (PDF)

2020 (PDF)

2019 (PDF)

2018 (PDF)

2017 (PDF)

2016 (PDF)

2015 (PDF)

2014 (PDF)

2013 (PDF)

2012 (PDF)

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

Percent of infants who received hepatitis B vaccine within 3 days of birth by delivery facility, NYC, 2012 (PDF)

Hepatitis B: What Hospitals Need to Do to Protect Newborns

Guidance for Developing Admission Orders in Labor & Delivery and Newborn Units to Prevent Hepatitis B Virus Transmission (PDF)

Sample Text for Developing Admission Orders in Newborn Units for the Hepatitis B Vaccine Birth Dose (PDF)

Hepatitis B Vaccine Information Statements

Criteria for inclusion on IAC's Hepatitis B Birth Dose Honor Roll

Application for Enrollment into the Hepatitis B Birth Dose Honor Roll

Hepatitis B Immunization Management of Preterm Infants Weighing < 2,000g, by Maternal Hepatitis B Surface Antigen (HBsAg) Status – Corrected Table 4 (PDF)

Hepatitis B Vaccine Coverage Among All Live Newborn Infants Prior to Hospital or Birthing Facility Discharge (NQF # 0475) (PDF)

Hepatitis B Vaccine Patient – Slide-sets

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

Audio-Visual

Hepatitis B Patient Handouts

How to Tell Others that You Have Chronic Hepatitis B (PDF)

Hepatitis B Shots Are Recommended for All New Babies. Hepatitis B Vaccine Helps Protect Your Baby’s Future! (brochure for parents of newborns)(PDF)

Hepatitis B – The Facts (General Hepatitis B Patient Brochure for NYC. Call 311 to order) (PDF)

Health Bulletin: Your Liver Keeps You Healthy: Protect It (PDF)

Prevention of Perinatal Hepatitis B for Healthcare Professionals

General

New York State Public Health Law - Section 2500-E (PDF)

New York City Health Code - SubPart 69-3

A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States Recommendations of the Advisory Committee on Immunization Practices (ACIP) Part 1: Immunization of Infants, Children, and Adolescents, MMWR, December 23, 2005/54(RR16) (PDF)

Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection, MMWR, September 19, 2008/57(RR08)

New York State Department of Health Perinatal Hepatitis B Prevention Program Manual (PDF)

For Prenatal Care Providers

Testing for Hepatitis B Virus Infection During Pregnancy - Flowchart for Prenatal Providers (PDF)

Vaccinations for Pregnant Women (PDF)

For Laboratories and Infection Control

NYC Health Code and Rules – Article 11- Reportable Diseases and Conditions (PDF)

NYC Health Code and Rules – Article 13 - Laboratories (PDF)

For Delivery Facilities

Procedures to Prevent Perinatal Hepatitis B Virus Transmission at Delivery (Maternal HBsAg Test Results Available)(PDF)

Procedures to Prevent Perinatal Hepatitis B Virus Transmission at Delivery (Maternal HBsAg Test Results Not Available)(PDF)

For Pediatricians

Recommended Immunization Schedules for Persons Aged 0 Through 18 Years, United States, 2015 (PDF)

Birth-18 Years & “Catch-up” Immunization Schedules, United States, 2015 (CDC)

More Information

Pregnancy and Baby Care