Abstract
BackgroundHepatitis B infection (HBV) is a major Public Health Problem.Perinatal transmission can be prevented with the identification of HBsAg(+) women and administration of immunoprophylaxis to their newborns. A national prevention programme for HBV with universal screening of pregnant women and vaccination of infants is in effect since 1998 in Greece.MethodsTo evaluate adherence to the national guidelines, all women delivering in Greece between 17–30/03/03 were included in the study. Trained health professionals completed a questionnaire on demographic data, prenatal or perinatal screening for HBsAg and the implementation of appropriate immunoprophylaxis.ResultsDuring the study period 3,760 women delivered. Prenatal screening for HBsAg was documented in 91.3%. Greek women were more likely to have had prenatal testing. HBsAg prevalence was 2.89% (95%CI 2.3–3.4%). Higher prevalence of HBV-infection was noted in immigrant women, especially those born in Albania (9.8%). Other risk factors associated with maternal HBsAg (+) included young maternal age and absence of prenatal testing. No prenatal or perinatal HBsAg testing was performed in 3.2% women. Delivering in public hospital and illiteracy were identifiable risk factors for never being tested. All newborns of identified HBsAg (+) mothers received appropriate immunoprophylaxis.ConclusionThe prevalence of HBsAg in Greek pregnant women is low and comparable to other European countries. However, immigrant women composing almost 20% of our childbearing population, have significant higher prevalence rates. There are still women who never get tested. Universal vaccination against HBV at birth and reinforcement of perinatal testing of all women not prenatally tested should be discussed with Public Health Authorities.
Highlights
Hepatitis B infection (HBV) is a major Public Health Problem.Perinatal transmission can be prevented with the identification of Hepatitis B surface antigen (HBsAg)(+) women and administration of immunoprophylaxis to their newborns
Only 5–10% of adults infected with Hepatitis B virus (HBV) will become chronic carriers, neonatal infection almost always leads to a chronic carrier state (90%) whereas 30–60% of children infected during the first five years of life will become chronic HBV carriers [4]
If prenatal screening for HBsAg was not documented, we noted whether examination of the HBsAg serostatus of the pregnant woman upon admission to the delivery room was ordered and whether appropriate immunoprophylaxis was given to the newborn
Summary
Perinatal transmission can be prevented with the identification of HBsAg(+) women and administration of immunoprophylaxis to their newborns. A national prevention programme for HBV with universal screening of pregnant women and vaccination of infants is in effect since 1998 in Greece. About one forth of them will develop chronic hepatitis and cirrhosis and could develop hepatocellular carcinoma eventually [1]. The precise mechanism of this has not yet been defined but it has been attributed to the immaturity of the immune system of newborns and young children and their inability to mount an effective CTL response against HBV infection[5,6]. Up to 25% of infants and older children who acquire chronic HBV infection will eventually develop HBV-related hepatocellular carcinoma or cirrhosis [7]
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