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Learning Objectives for this Presentation:
The objectives for this study were to assess hospital HBsAg screening practices of women who present for delivery with no prenatal care and to assess hospital perinatal hepatitis B prevention practices of infants born to women who present for delivery with no prenatal care.
Background:
Infants born to hepatitis B surface antigen (HBsAg) positive women are at extremely high risk of perinatal transmission and chronic infection. However, post-exposure prophylaxis given within 12 hours of birth is 90 -95% effective in preventing perinatal infection. Women who do not receive prenatal care are less likely to have been screened for HBsAg and could possibly have a higher HBsAg positivity rate.
Methods:
We reviewed medical charts of women (690) who presented for delivery with no record of prenatal care and of their infants (701) in 25 birthing hospitals.
Results:
In regards to the mothers' records, documented HBsAg results were found on 607 (88%) women in the survey. There was no record that an HBsAg test was ordered for 29 women (4%). Of these 29 moms, 25 (86%) moms came from seven hospitals (two were “universal” birth dose hospitals). In regards to the infants' records, 14 infants who were born to women whose HBsAg status was unknown at discharge were not vaccinated. Of these 14 infants, 12 (86%) mismanaged infants came from five hospitals (one “universal” birth dose hospital).
Conclusions:
All hospitals surveyed are conducting HBsAg screening on the majority of women that have no record of prenatal care. All hospitals surveyed are vaccinating the majority of infants born to women that have positive or unknown HBsAg status. The California Department of Health Services needs to support hospitals to improve the HBsAg testing of moms admitted with unknown status; the vaccination of infants born to moms of unknown HBsAg status within 12 hours of birth; and documentation practices.
See more of I1 - Hospital Based Assessment of Hepatitis B Screening of Pregnant Women
See more of The 2005 National Viral Hepatitis Prevention Conference