Assessing perinatal hepatitis B screening and neonatal prophylaxis in a large, multiethnic county.
OBJECTIVE
To assess the completeness of maternal screening and appropriateness of newborn prophylaxis for hepatitis B virus (HBV) in 2001 in Florida's largest county.


METHODS
A retrospective cohort study sampled 1% of deliveries at all hospitals in Miami-Dade County that had delivery suites. Abstractors reviewed mothers' and newborns' charts before discharge to determine whether newborns received appropriate HBV prophylaxis based on mothers' hepatitis B virus surface antigen (HBsAg) status at 12 hours postpartum. At each hospital, deliveries were sampled sequentially until the target number was reached. Sampling was donefor March-August 2001.


RESULTS
Among 339 deliveries at 14 hospitals, the mother's HBsAg status was known within 12 hours of delivery for 286, or 84.4% (95% CI 80.1-88.1%). Of the 53 infants whose mothers' HBsAg status was unknown, 15 (28.3%) were vaccinated within 12 hours of delivery; both infants whose mothers were HBsAg positive received vaccine and immune globulin within 12 hours delivery.


CONCLUSIONS
While HBsAg screening of pregnant women is widespread in Miami-Dade County, the information is not consistent used to protect infants who mothers' HBsAg status unknown.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, Florida 33136, USA. vhgonzalez@med.miami.edu
Victor Hugo
VH
González-Quintero
Dolly
D
Katz
Indra
I
Pandya-Smith
Lama
L
Tolaymat
Mary Jo
MJ
O'Sullivan
D000704:Analysis of Variance; D015331:Cohort Studies; D016001:Confidence Intervals; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida / Q000453:epidemiology; D005500:Follow-Up Studies; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D019694:Hepatitis B, Chronic / Q000151:congenital* / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D016015:Logistic Models; D015997:Neonatal Screening; D018743:Perinatal Care; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011322:Primary Prevention / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D014611:Vaccination / Q000379:methods
D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines