title: Outcomes of infants born to women infected with hepatitis B.
abstract: OBJECTIVE
  Perinatal exposure is an important mode of hepatitis B virus (HBV) transmission, resulting in chronic disease in ∼ 90% of infected infants. Immunoprophylaxis recommended for infants born to hepatitis B surface antigen-positive mothers reduces up to 95% of perinatal HBV infections. We sought to identify factors associated with perinatal HBV transmission.
  
  
  METHODS
  We analyzed prospectively collected data from 5 of 64 US-funded Perinatal Hepatitis B Prevention Programs during 2007-2013. We examined effects of maternal demographic and laboratory results, infant gestational age and birth weight, and immunoprophylactic management on perinatal HBV infection.
  
  
  RESULTS
  Data from 17,951 mother-infant pairs were analyzed. Among 9252 (51.5%) infants for whom hepatitis B surface antigen testing results were available, 100 (1.1%) acquired perinatal HBV infection. Both hepatitis B (HepB) vaccine and hepatitis B immune globulin were administered within 12 hours of birth for 10,760 (94.9%) of 11,335 infants with information. Perinatal HBV infection was associated with younger maternal age (P = .01), Asian/Pacific Islander race (P < .01), maternal hepatitis B e-antigen positivity (P < .01), maternal antibody to hepatitis B e-antigen negativity (P < .01), maternal viral load ≥ 2000 IU/mL (P = .04), and infant receipt of <3 HepB vaccine doses (P = .01). Four infants born to 429 mothers with viral load testing were infected; all 4 were born to mothers with viral loads in the ninth or tenth decile.
  
  
  CONCLUSIONS
  Perinatal HBV infection occurred among 1% of infants, most of whom received recommended immunoprophylaxis. Infants at greatest risk of infection were those born to women who were younger, hepatitis B e-antigen positive, or who had a high viral load or those infants who received <3 HepB vaccine doses.
authors.affiliation: Divisions of Viral Hepatitis, sschillie@cdc.gov.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schillie
authors.affiliation: HIV/AIDS Prevention, and.
authors.forename: Tanja
authors.initials: T
authors.lastname: Walker
authors.affiliation: Divisions of Viral Hepatitis.
authors.forename: Steven
authors.initials: S
authors.lastname: Veselsky
authors.affiliation: Minnesota Department of Health, St Paul Minnesota;
authors.forename: Susan
authors.initials: S
authors.lastname: Crowley
authors.affiliation: Florida Department of Health, Tallahassee, Florida;
authors.forename: Cristina
authors.initials: C
authors.lastname: Dusek
authors.affiliation: New York City Department of Health and Mental Hygiene, New York, New York;
authors.forename: Julie
authors.initials: J
authors.lastname: Lazaroff
authors.affiliation: Texas Department of State Health Services, Austin, Texas; and.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Morris
authors.affiliation: Michigan Department of Community Health, Lansing, Michigan.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Onye
authors.affiliation: Divisions of Viral Hepatitis.
authors.forename: Stephen
authors.initials: S
authors.lastname: Ko
authors.affiliation: Immunization Services, Centers for Disease Control and Prevention, Atlanta, Georgia;
authors.forename: Nancy
authors.initials: N
authors.lastname: Fenlon
authors.affiliation: Divisions of Viral Hepatitis.
authors.forename: Noele P
authors.initials: NP
authors.lastname: Nelson
authors.affiliation: Divisions of Viral Hepatitis.
authors.forename: Trudy V
authors.initials: TV
authors.lastname: Murphy
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000635:transmission*; D006513:Hepatitis B e Antigens / Q000097:blood; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood; D011256:Pregnancy Outcome; D011446:Prospective Studies
chemical_list: D006513:Hepatitis B e Antigens
keywords: hepatitis B; immunization; perinatal; vaccine