Compliance with antenatal screening for hepatitis B surface antigen carrier status in pregnant women and consecutive procedures in exposed newborns

Abstract

The goal of this study was to determine compliance with official recommendations for prevention of perinatal hepatitis B virus transmission from hepatitis B surface antigen (HBsAg) positive mothers to their offspring. All infants born to HBsAg positive mothers at the University Women's Hospital in Basel, Switzerland, in 2001 were identified and post-exposure immunisations were analysed. In addition, detailed written information on subsequent hepatitis B immunisations was obtained from the infants' paediatricians. A total of 1513 women gave birth to 1554 children and screening for HBsAg had been performed in 1503 (99%) women, of whom 8% were screened during delivery. A group of 18 (1.2%) women were HBsAg positive and 17 (95%) of the 19 exposed infants promptly received active and passive immunisation. One exposed infant was lost to follow-up and in one, postnatal vaccination was missed. Of the remaining 17 exposed infants, 9 (53%) received the full course of three active immunisations, but only two (12%) were immunised within the recommended time frame. On follow-up, six children were still too young for serological testing for successful immunisation. Among the remaining 11 immunised infants, serological testing had been performed in 4 (36%).

Conclusion: Compliance with recommendations for hepatitis B surface antigen screening was excellent in this study. The proportion of exposed infants receiving all three active immunisations was satisfactory, but more attention must be paid to complete and timely administration and serological testing in the future. This will require improved communication between neonatology units and care-providing paediatricians in private practices.