Nursing

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Screening for Hepatitis B Virus Infection in Pregnancy: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement
Annals of Internal Medicine, 06/16/09

Reaffirmation of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for hepatitis B virus hepatitis B virus infection in pregnancy. The USPSTF performed a brief literature update, including a search for new and substantial evidence on the benefits and harms of screening pregnant women for hepatitis B virus infection. The USPSTF recommends screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit. (This is a grade A recommendation.)

Screening Tests: Serologic identification of hepatitis B surface antigen (HBsAg). Reported sensitivity and specificity are greater than 98%.

Timing of Screening:

• Order HBsAg testing at the first prenatal visit.
• Rescreen women with unknown HBsAg status or new or continuing risk factors at admission to hospital, birth center, or other delivery setting.

Interventions:

• Administer hepatitis B vaccine and hepatitis B immune globulin to HBV-exposed infants within 12 hours of birth.
• Refer women who test positive for counseling and medical management.
• Counseling should include information about how to prevent transmission to sexual partners and household contacts.
• Reassure patients that breastfeeding is safe for infants who receive appropriate prophylaxis.

Implementation: Establish systems for timely transfer of maternal HBsAg test results to the labor and delivery and newborn medical records.