Assessment of Perinatal Hepatitis B and Rubella Prevention in New Hampshire Delivery Hospitals

Abstract

ABSTRACT.Objective. To evaluate current performance on recommended perinatal hepatitis B and rubella prevention practices in New Hampshire.Methods. Data were extracted from 2021 paired mother-infant records for the year 2000 birth cohort in New Hampshire's 25 delivery hospitals. Assessment was done on the following: prenatal screening for hepatitis B and rubella, administration of the hepatitis B vaccine birth dose to all infants, administration of hepatitis B immune globulin to infants who were born to hepatitis B surface antigen-positive mothers, rubella immunity, and administration of in-hospital postpartum rubella vaccine to rubella nonimmune women.Results. Prenatal screening rates for hepatitis B (98.8%) and rubella (99.4%) were high. Hepatitis B vaccine birth dose was administered to 76.2% of all infants. All infants who were born to hepatitis B surface antigenpositive mothers also received hepatitis B immune globulin. Multivariate logistic regression showed that the month of delivery and infant birth weight were independent predictors of hepatitis B vaccination. The proportion of infants who were vaccinated in January and February 2000 (48.5% and 67.5%, respectively) was less than any other months, whereas the proportion who were vaccinated in December 2000 (88.2%) was the highest. Women who were born between 1971 and 1975 had the highest rate of rubella nonimmunity (9.5%). In-hospital postpartum rubella vaccine administration was documented for 75.6% of nonimmune women.Conclusion. This study documents good compliance in New Hampshire's birthing hospitals with national guidelines for perinatal hepatitis B and rubella prevention and highlights potential areas for improvement. Pediatrics 2005;115:e594-e599. URL: www.pediatrics.org/ cgi

Gaps in the prevention of perinatal transmission of hepatitis B virus between recommendations and routine practices in a highly endemic region: a provincial population-based study in China

“…Prenatal HBsAg screening has been recommended in all pregnant women in China since the late of 1980s, however, the actual screening rate in the present investigation was only 52.3%, far from the rates of 90–99% in developed countries [19-22]. The gap is particularly substantial in the rural areas as only 46.9% of pregnant women underwent the prenatal screening.…”

Efficacy of antigen dosage on the hepatitis B vaccine response in infants born to hepatitis B-uninfected and hepatitis B-infected mothers

“…In our study, problems with the sensitivity and specificity of the HBV ELISA kit caused some pregnant women who originally tested HBeAg negative to be later identified as HBeAg positive. While maternal HBsAg screening has been recommended for all pregnant women in China since 1980, logistical challenges in the testing laboratories and a lack of health care awareness have led to lower HB screening and accuracy rates in China than in other developed countries [29][30][31]. In addition, HBIg is derived from blood, and therefore, has limited availability, especially in rural areas.…”

Rubella seronegativity in antenatal screening – Is it influenced by the introduction of universal childhood rubella immunization?

“…A rubella-specific antibody titer of <10 IU/ml usually equates susceptibility, predisposing to fetal congenital rubella syndrome (CRS) if infection occurs in pregnancy. Rubella susceptibility is influenced by age, immunization compliance, gravidity and parity, and country of origin/birth [11][12][13][14][15][16][17][18], the last factor probably being the most important as Asians and Chinese have either accounted for the majority of rubella seronegative women, or an overall lower rate of seropositivity or antibody titer, compared with Caucasians in multiethnic communities [11,13,14,18,19]. Country of origin/birth could also impact through epidemiological factors, such as chronic hepatitis B virus (HBV) infection, which was associated with increased antenatal rubella seronegative status in Hong Kong [20].…”