25565 An Assessment of Perinatal Hepatitis B Prevention Policies In Kansas Hospitals

Tuesday, March 29, 2011
Columbia Hall
Elizabeth Lawlor, MS , Epidemiologist, Kansas Department of Health and Environment

Background:  Hepatitis B virus (HBV) is spread via blood, and vertical transmission (mother to child) during the perinatal period is one of the most efficient methods of transmission.  HBV-positive women have up to a 90% chance of transmitting the virus to their infant.  However, proper chemoprophylaxis has been shown to be 85-95% effective in preventing an infant from becoming a chronic carrier of HBV, which can result in significant morbidity and mortality.   The Advisory Committee on Immunization Practices has published guidelines addressing testing, treatment and documentation of HBV-positive women and their infants. 

Objectives:   The objective was to assess the policies and procedures concerning prevention of perinatal HBV transmission in addition to other perinatal infections at birthing hospitals throughout Kansas.

Methods:  A survey was created to meet the objectives of the study.  This survey was based on a previous survey created by the CDC.  Questions were asked to assess the existence of standing orders and written policies regarding prevention of perinatally acquired HBV.  The surveys were mailed to the directors of labor and delivery (L&D) at Kansas birthing hospitals. 

Results:  There was a 93% response rate for the survey.  Eighty-five percent of hospitals had a hepatitis B birthdose policy, and only 82% of hospitals had a policy to administer the hepatitis B vaccine within twelve hours of birth to infants born to HBV-positive women.  Hospitals with a greater number of births annually (500+/year) were at least 5 times more likely to have policies than those with fewer number of births (<100/year, 100-499/year) regarding the identification of women at risk for transmitting HBV to their infants, as well as the documentation of maternal lab results. 

Conclusions:  Further education of birthing hospitals in the state of Kansas needs to be performed in order to ensure that hospitals have policies in place to prevent this severe, life-threatening illness.