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Questions and Answers About Prenatal Hepatitis B Screening

A screening test during your first prenatal visit can identify the virus early.

mother and father talking with son

Hepatitis B, or HBV, is one of several hepatitis viruses that can damage the liver. If you are expecting and have hepatits B, you run the risk of passing it to your baby when he or she is born. Getting tested and knowing your results can help you protect your baby, even if you test positive.

How does the virus spread?

HBV spreads from person to person by direct contact with infected blood or body fluids. HBV can spread by:

  • Having sexual contact with an infected person
  • Sharing needles, syringes or other drug-injection equipment
  • Being exposed to blood from needlesticks or other sharp instruments
  • Sharing razors or toothbrushes with someone who has the virus

In pregnant women, an infected mother can give her baby the virus during birth.

Who is at risk of getting the virus?

You are at higher risk for hepatitis B if you:

  • Have sex with someone who has it
  • Have many sexual partners
  • Have a sexually transmitted disease
  • Are a man who has sex with other men
  • Inject drugs or share needles or other drug equipment
  • Live in the same household with someone with chronic hepatitis B
  • Were born to an infected mother
  • Undergo hemodialysis
  • Have a job that exposes you to human blood
  • Travel to places with moderate to high rates of hepatitis B

You may not even know you have HBV. You may not look or feel ill. If you have the virus and are pregnant, you may give it to your baby when he or she is born. However, a simple screening test done during your first prenatal visit can identify if you are infected with the virus. Then you can take steps to protect your baby.

What could happen to my baby?

If your baby becomes infected and is not treated, he or she may face serious health problems or even death. Most newborns who are infected don’t show symptoms, but have up to a 90 percent chance of developing chronic hepatitis B. Hepatitis B becomes chronic when the virus remains in the body and becomes a long-term illness. People with chronic HBV have up to a 25 percent risk of developing serious liver conditions such as cirrhosis or liver cancer.

How is  the hepatitis B screening performed?

The screening takes some of your blood and tests it to see if you have an antigen, or protein, that occurs in the blood of people with hepatitis B.

The hepatitis B surface antigen is a protein on the surface of HBV. If you have HBV, the antigen will show up in your blood. In response to this infection, your body makes antibodies.

What do the results mean?

A negative test result means that no hepatitis B surface antigen is present in your blood. You most likely do not have hepatitis B.

A positive test result means the hepatitis B surface antigen was found in your blood.

How do I protect my baby if my hepatitis B blood test is positive?

Experts recommend that your newborn get two shots within 12 hours of birth. The first is the HBV vaccine. The second has hepatitis B immune globulin. The next two HBV vaccinations will be given with routine baby shots when your baby is about six months old.

Everyone in your household should also be tested for HBV. If they also have HBV, they should be vaccinated.

Can I get vaccinated against hepatitis B if I am pregnant?

If you don’t have hepatitis B but are at high risk for getting it, your doctor may advise you to get the vaccine. There is no known risk to your unborn baby or to yourself. The vaccine does not contain live virus.

Will my baby need the hepatitis B vaccine even if my blood test is negative?

An HBV vaccine is recommended for all infants so they can be protected for a serious, preventable disease. If they get infected, babies and children are at higher risk for it developing into a chronic infection. The baby will not need a shot of hepatitis B globulin, but still needs the hepatitis B vaccine series. Most schools now require that your child be immunized for HBV before you can register them for school.

By Susan G. Warner, Contributing Writer

American College of Obstetricians and Gynecologists. Hepatitis B in pregnancy. Accessed: July 14, 2016.
U.S. Preventive Services Task Force. Screening for hepatitis B virus infection in pregnancy. AccessedJuly 14, 2016.
Centers for Disease Control and Prevention. Guidelines for vaccinating pregnant women. Accessed: July 14, 2016.

Last Updated: July 15, 2016