No. 342-Hepatitis B and Pregnancy

Abstract

Objective: To review the epidemiology, natural history, evaluation, and treatment of hepatitis B virus (HBV) infection during pregnancy. This will aid obstetric care providers in counseling their patients regarding perinatal risks and management options available to pregnant women with hepatitis B.

Outcomes: Outcomes evaluated include thresholds for HBV anti-viral treatment for prevention of perinatal transmission and for invasive procedures during pregnancy for women with hepatitis B infection.

Evidence: Medline, EMBASE, and CINAHL were searched for articles in English on subjects related to HBV infection, pregnancy, and perinatal transmission from 1966 to March 2016. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Other (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical speciality societies.

Validation methods: The quality of the evidence is rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Recommendations for practice are ranked according to the method described in this Report.

Guideline update: The guideline will be reviewed 5 years after publication to decide if an update is required. However, if important new evidence is published prior to the 5-year cycle, the review process may be accelerated for a more rapid update of some recommendations.

Sponsors: This guideline was developed with resources funded by the Society of Obstetricians and Gynaecologists of Canada.

Keywords: Hepatitis B; antiviral therapy; breast-feeding; chronic hepatitis; immuno-prophylaxis; pregnancy; vertical transmission; viral load.