Antenatal hepatitis B screening - is there a need for a national policy?
Routine antenatal testing for hepatitis B carriage with maternal consent was introduced at the Rotunda in January 1998. The uptake of testing has been excellent; 99.98% of women presenting for antenatal care accepted hepatitis B (HBV) screening in the 30-months from January 1998 through June 2000. The prevalence of HBV carriage was 0.35% (58 pregnancies of 16,222 tested) increasing from 0.25% in 1998 (16 of 6227) to 0.45% in the first six months of 2000 (16 of 3484). Fifty-five women had 58 pregnancies (three women had two pregnancies). Two of these were e-antigen positive. HBV carrier status was previously unknown in 48 (87%). Two additional women had acute HBV infection in pregnancy. Forty-five infants have been born to mothers included in this screening programme. Audit of infant outcome reveals excellent compliance with immunisation and follow-up: 29 (64%) have completed the 3 dose HBV vaccination schedule to date. Thirteen infants (31%) are still attending; three are lost to follow-up including one whose family has emigrated. Routine antenatal screening for hepatitis B carriage is cost-effective and should be considered a standard of care in maternity practice.
Healy
C M
CM
Rotunda Hospital, Dublin.
Cafferkey
M T
MT
Butler
K M
KM
Cahill
I
I
McMorrow
J
J
Philbin
M
M
Beckett
M
M
Mackey
R
R
MacMathuna
P
P
Dooley
S
S
Hall
W W
WW
McKenna
P
P
D002353:Carrier State; D005260:Female; D006291:Health Policy; D006509:Hepatitis B / Q000517:prevention & control / Q000635:transmission*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D007494:Ireland / Q000453:epidemiology; D008403:Mass Screening; D010865:Pilot Projects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D011296:Prenatal Diagnosis
D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines