title: Seroprevalence of hepatitis B infection during pregnancy and risk of perinatal transmission.
abstract: OBJECTIVE
  To investigate the seroprevalence of hepatitis B surface antigen (HBsAg) in pregnant women and possible risk factors for perinatal hepatitis B virus (HBV) transmission.
  
  
  METHODS
  Four thousand pregnant women were evaluated using history, examination, and test for serum HBsAg using commercial enzyme immunoassay kits. For HBsAg positive women, liver function tests and a test for hepatitis B e antigen (HBeAg) was done. HBV DNA analysis was done by polymerase chain reaction (PCR).
  
  
  RESULTS
  Of 4,000 women studied, 37 (0.9%) tested positive for HBsAg. Of these 37 women, 6 (16%) presented with acute hepatitis and 31 (84%) were asymptomatic. The highest HBsAg positivity rate was seen in the age group of 21-25 years (1.15%) followed by 26-30 years (0.86%). Assessment of risk factors revealed history of tattooing in 29/37 (78.4%) women. HBeAg was positive in 21 of 37 (56.8%) women. Of the 16 HBeAg negative women, 5 were positive for HBV DNA and anti-HBe antibody, 6 had only anti-HBe antibody and 5 had neither HBV DNA nor anti-HBe. Vertical transmission was seen in 65% (13/20) of babies born to mothers who were positive for HBeAg and HBV DNA. In contrast, it was only 9.1% (1/11) for babies born to mothers who were negative for both HBeAg and HBV DNA. Of the 25 babies delivered vaginally, 15 (60%) developed vertical transmission. None of the four babies delivered by elective cesarean section had evidence of vertical transmission.
  
  
  CONCLUSIONS
  Seroprevalence of HBsAg in antenatal women was found to be 0.9%. HBe-antigen and HBV DNA positivity was associated with a higher chance of vertical transmission.
authors.affiliation: Department of Gastroenterology, Moti Lal Nehru Medical College, Allahabad, 211 001. India, mani_1952@rediffmail.com
authors.forename: Manisha
authors.initials: M
authors.lastname: Dwivedi
authors.forename: Sri Prakash
authors.initials: SP
authors.lastname: Misra
authors.forename: Vatsala
authors.initials: V
authors.lastname: Misra
authors.forename: Arvind
authors.initials: A
authors.lastname: Pandey
authors.forename: Sanjay
authors.initials: S
authors.lastname: Pant
authors.forename: Rita
authors.initials: R
authors.lastname: Singh
authors.forename: Manju
authors.initials: M
authors.lastname: Verma
mesh_terms: D000293:Adolescent; D000328:Adult; D017931:DNA Primers / Q000737:chemistry; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000635:transmission*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D007124:Immunoenzyme Techniques; D007194:India / Q000453:epidemiology; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D017931:DNA Primers; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens