UMMS Affiliation

Department of Population and Quantitative Sciences, Division of Preventive and Behavioral Medicine; UMass Worcester Prevention Research Center

Publication Date

2019-07-23

Document Type

Article

Disciplines

Behavioral Medicine | Community Health and Preventive Medicine | Diagnosis | Digestive System Diseases | Health Services Administration | Health Services Research | Maternal and Child Health | Preventive Medicine | Public Health Education and Promotion | Virus Diseases

Abstract

Importance: Screening for hepatitis B virus (HBV) infection during pregnancy identifies women whose infants are at risk of perinatal transmission. Data from a nationally representative sample showed a prevalence of maternal HBV infection of 85.8 cases per 100000 deliveries from 1998 to 2011 (0.09% of live-born singleton deliveries in the United States). Although there are guidelines for universal infant HBV vaccination, rates of maternal HBV infection have increased annually by 5.5% since 1998. Children infected with HBV during infancy or childhood are more likely to develop chronic infection. Chronic HBV infection increases long-term morbidity and mortality by predisposing infected persons to cirrhosis of the liver and liver cancer.

Objective: To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for HBV infection in pregnant women.

Evidence Review: The USPSTF commissioned a reaffirmation evidence update to identify substantial new evidence sufficient enough to change the prior recommendation. The USPSTF targeted its evidence review on the effectiveness and potential harms of screening and the effectiveness and harms of case management to prevent perinatal transmission.

Findings: The USPSTF previously found adequate evidence that serologic testing for hepatitis B surface antigen accurately identifies HBV infection. Interventions are effective for preventing perinatal transmission, based on foundational evidence and observational studies of US case management programs. In addition, there is evidence that over time, perinatal transmission has decreased among women and infants enrolled in case management, providing an overall substantial health benefit. Therefore, the USPSTF reaffirms its previous conclusion that there is convincing evidence that screening for HBV infection in pregnant women provides substantial benefit.

Conclusions and Recommendation: The USPSTF recommends screening for HBV infection in pregnant women at their first prenatal visit. (A recommendation).

Keywords

hepatitis B virus (HBV) infection, screening, pregnancy, recommendation

Rights and Permissions

© 2019 American Medical Association. Publisher PDF posted after 6 months as allowed by the publisher's author rights policy at https://jamanetwork.com/journals/jama/pages/instructions-for-authors#SecDepositingResearchArticlesinApprovedPublicRepositories.

DOI of Published Version

10.1001/jama.2019.9365

Source

JAMA. 2019 Jul 23;322(4):349-354. doi: 10.1001/jama.2019.9365. Link to article on publisher's site

Journal/Book/Conference Title

JAMA

Comments

Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

PubMed ID

31334800

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