Proposal for routine antenatal screening at 14 weeks for hepatitis B surface antigen. Dutch Study Group on Prevention of Neonatal Hepatitis.
OBJECTIVE
To develop a low cost, high compliance screening programme for identification of carriers of hepatitis B surface antigen in the obstetric population of the Netherlands.


METHODS
A seven year open, descriptive study of screening for hepatitis B surface antigen as part of routine prenatal laboratory testing at 14 weeks of gestation. Compliance with programme evaluated by checking delivery records (hospitals) or registration of births in the 30 participating municipalities (rural area).


METHODS
Three large city hospitals (two tertiary referral centres) and one rural area with a large number of home deliveries.


METHODS
99,706 pregnant women applying for prenatal care for the first time.


METHODS
Proportion of pregnant women routinely screened; prevalence of hepatitis B surface antigen in large cities and rural area.


RESULTS
Uptake of screening reached 97% in the hospitals after inclusion of 10% screened at delivery; the estimated uptake in the rural area was > 95%. Prevalence of hepatitis B surface antigen was 1.6% in the large cities and 0.3% in the rural area. For screening at delivery the prevalence was 2.5 times higher (4%, P < 0.01) than for screening at week 14 of gestation.


CONCLUSIONS
Incorporation of universal testing for hepatitis B surface antigen into routine prenatal laboratory testing is practical; high compliance is achieved when screening is supplemented with rapid screening at delivery for those who escaped routine prenatal care.
D000293:Adolescent; D000328:Adult; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000191:economics / Q000379:methods; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D013997:Time Factors; D014504:Urban Health
D006514:Hepatitis B Surface Antigens