Outcomes from a Canadian public health prenatal screening program for hepatitis B: 1997-2004.
BACKGROUND
Without appropriate prophylaxis, the rate of vertical transmission of hepatitis B virus (HBV) can be as high as 95%. Alberta's provincial prenatal program screens all pregnant women for HBV, and provides prophylaxis to infants born to HBV-infected women. Canadian data on the outcomes of such programs are limited.


METHODS
We conducted a retrospective review of data from pregnant Albertan women who were Hepatitis B Surface Antigen (HBsAg) positive from 1997-2004. We describe the frequency of hepatitis B immunoglobulin (HBIG) and vaccine administration, follow-up serology and pregnancy outcomes.


RESULTS
In total, 1,485 HBsAg-positive pregnant women were identified; an average of 186 women annually (range: 125-216). Of the 980 infants eligible to have completed prophylaxis and serological follow-up, 82.0% were appropriately immunized and serologically tested, 11.3% had complete immunization but no serology testing and 6.6% were incompletely immunized. Of infants with complete immunization and follow-up, 3.7% failed to mount an immune response and 2.1% were infected.


CONCLUSIONS
A high proportion of infants born to carrier mothers are receiving appropriate post-natal prophylaxis in Alberta. Future research should examine maternal factors that may increase the vertical transmission of HBV.
Plitt
Sabrina S
SS
Centre for Infectious Disease Control and Prevention, Public Health Agency of Canada, Ottawa, ON.
Somily
Ali M
AM
Singh
Ameeta E
AE
D000293:Adolescent; D000328:Adult; D000416:Alberta; D002170:Canada; D018890:Chemoprevention; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis* / Q000517:prevention & control; D006514:Hepatitis B Surface Antigens; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008403:Mass Screening; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000517:prevention & control; D011296:Prenatal Diagnosis; D015397:Program Evaluation; D012189:Retrospective Studies; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage*
D006514:Hepatitis B Surface Antigens; D014761:Viral Hepatitis Vaccines