title: Trends in the prevalence of hepatitis B infection among women giving birth in New South Wales.
abstract: OBJECTIVE
  To evaluate the effect of targeted and catch-up hepatitis B virus (HBV) vaccination programs in New South Wales on HBV prevalence among women giving birth for the first time.
  
  
  METHODS
  Observational study linking data from the NSW Perinatal Data Collection for women giving birth during 2000-2012 with HBV notifications in the NSW Notifiable Conditions Information Management System.
  
  
  METHODS
  HBV prevalence in Indigenous Australian, non-Indigenous Australian-born, and overseas-born women giving birth.
  
  
  RESULTS
  Of 482 944 women who gave birth to their first child, 3383 (0.70%) were linked to an HBV notification. HBV prevalence was 1.95% (95% CI, 1.88-2.02%) among overseas-born women, 0.79% (95% CI, 0.63-0.95%) among Indigenous Australian women, and 0.11% (95% CI, 0.09-0.12%) among non-Indigenous Australian-born women. In Indigenous Australian women, prevalence was significantly lower for those who had been eligible for inclusion in the targeted at-risk newborn or universal school-based vaccination programs (maternal year of birth, 1992-1999: 0.15%) than for those who were not (born ≤ 1981: 1.31%; for trend, P < 0.001). There was no statistically significant downward trend among non-Indigenous Australian-born or overseas-born women. HBV prevalence was higher among Indigenous women residing in regional and remote areas than those in major cities (adjusted odds ratio [aOR], 2.23; 95% CI, 1.40-3.57), but lower for non-Indigenous (aOR, 0.39; 95% CI, 0.28-0.55) and overseas-born women (aOR, 0.61; 95% CI, 0.49-0.77).
  
  
  CONCLUSIONS
  Among women giving birth, there was a significant reduction in HBV prevalence in Indigenous women associated with the introduction of the HBV vaccination program in NSW, although prevalence remains higher than among non-Indigenous Australian-born women, and it also varies by region of residence. Continuing evaluation is needed to ensure that the prevalence of HBV infections continues to fall in Australia.
authors.affiliation: UNSW Sydney, Sydney, NSW lucy.deng@health.nsw.gov.au.
authors.forename: Lucy
authors.initials: L
authors.lastname: Deng
authors.affiliation: The Kirby Institute, UNSW Sydney, Sydney, NSW.
authors.forename: Joanne
authors.initials: J
authors.lastname: Reekie
authors.affiliation: South Australian Health and Medical Research Institute, Adelaide, SA.
authors.forename: James S
authors.initials: JS
authors.lastname: Ward
authors.affiliation: UNSW Sydney, Sydney, NSW.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hayen
authors.affiliation: The Kirby Institute, UNSW Sydney, Sydney, NSW.
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.affiliation: The Kirby Institute, UNSW Sydney, Sydney, NSW.
authors.forename: Marlene
authors.initials: M
authors.lastname: Kong
authors.affiliation: Aboriginal Health and Medical Research Council, Sydney, NSW.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Hunt
authors.affiliation: UNSW Sydney, Sydney, NSW.
authors.forename: Bette
authors.initials: B
authors.lastname: Liu
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control; D006515:Hepatitis B virus; D006801:Humans; D017589:Immunization Programs; D007231:Infant, Newborn; D016015:Logistic Models; D032541:Mass Vaccination / Q000706:statistics & numerical data*; D009517:New South Wales / Q000453:epidemiology; D016017:Odds Ratio; D010298:Parity; D044382:Population Groups / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D012042:Registries; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples