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Infectious Disease Epidemiology, Prevention and Control Division

651-201-5414

Perinatal Hepatitis B Prevention Pocket Guide - Pediatric

Pocket guide to assist pediatric health care providers with recommended strategies to prevent perinatal transmission of hepatitis B.

Order the Perinatal Hepatitis B Prevention Pocket Guides using the Perinatal Hepatitis B Materials - Order Form

On this page:
Management of Pregnant Women
Management of Delivery and Infant
Infants Born to HBsAg-positive Mothers

Prenatal HBsAg Testing

Test ALL pregnant women during an early prenatal visit in EACH pregnancy, even if tested before or previously vaccinated.
Send copy of lab report with the HBsAg-positive results to the delivery hospital and the infant’s health care provider.
Report to MDH all HBsAg-positive women within one working day of knowledge of the pregnancy.

At admission for delivery:

Review HBsAg status of all pregnant women. Perform STAT testing if HBsAg result for the current pregnancy is unavailable.
Retest HBsAg-negative women (at time of hospital delivery) if high-risk for infection:
- Injection-drug use
- More than one sex partner in 6 months
- HBsAg-positive sexual partner
- Evaluated/treated for STD
- Exhibits clinical hepatitis symptoms
Place copy of maternal HBsAg results in labor/delivery record, infant’s delivery summary, and nursery medical record.

After delivery:

ALL infants should receive:	If mother's HBsAg status is:	Also give infant:
Hep B vaccine within 12 hours of birth	Positive	HBIG within 12 hours of birth
	Negative	No HBIG needed
	Unknown (at discharge)	Give HBIG if test positive (must be given within 7 days of birth)

Preterm infants weighing less than 2,000g:
- Born to HBsAg-positive mothers: give hep B vaccine and HBIG within 12 hours of birth.
- Born to HBsAg-negative mothers: give first dose of hep B vaccine at one month of age.
- Born to mothers whose HBsAg status is unknown: give hep B vaccine and HBIG within 12 hours of birth.

Report to MDH all infants born to HBsAg-positive women within 24 hours of birth.
Completion of hepatitis B vaccine series at 1-2 months and
6 months of age.
Administration of 4 doses of hepatitis B vaccine is permissible when giving combination vaccines after the birth dose.
Perform post-vaccination serology at 9-12 months.
Test for both HBsAg and anti-HBs.
Report all vaccine dates and serology results to local and/or state health department.

Interpretation of Serology Results
Result	Follow-up needed
Anti-HBs positive HBsAg-negative	None. Infant is protected.
Anti-HBs negative HBsAg-negative	No response. Infant is susceptible to infection. Repeat hep B monovalent vaccine series using an accelerated schedule of 0, 1, and 4 months. Recheck serology 1-2 months after third dose.
Anti-HBs negative HBsAg-positive	Infant is infected with hepatitis B. Consult with liver specialist for follow-up and ongoing care.
Remember to report HBsAg-positive test results to MDH.