Universal Screening Of Pregnant Women Research Articles

Prevalence of thyroid dysfunction during first trimester of pregnancy: A descriptive cross‐sectional study

AbstractObjectivesThyroid dysfunction carries large burden during pregnancy and untreated thyroid dysfunction is associated with poor maternal and foetal outcome. The exact burden of thyroid dysfunction during pregnancy in Nepal is not well established. This is descriptive cross‐sectional study done in tertiary care centre of Nepal to know burden of thyroid dysfunction and establish possible need of universal thyroid function screening during pregnancy.MethodsA descriptive cross‐sectional study was conducted from 4 September 2020 to 3 September 2021 on pregnant women attending to ANC clinic during their first trimester after obtaining ethical approval. Among eligible patients, after taking informed consent, a total of 385 pregnant women were included in the study. Thyroid function status was assessed by measuring serum levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri‐iodothyronine (FT3). Women with pre‐existing thyroid disorders were excluded. Serum thyroid function was used to detect thyroid disorder based on American Thyroid Association 2011 criteria. A convenience sampling method was used. Point estimate and 95% confidence interval (CI) were calculated.ResultsAmong 385 pregnant women, 152 (39.48%) (39.20–39.70, 95% CI) had thyroid disorders. Among thyroid disorders (n = 152), 111 (28.83%) had subclinical hypothyroidism, 37 (9.61%) overt hypothyroidism, 3 (0.78%) subclinical hyperthyroidism and 1 (0.26%) had overt hyperthyroidism.ConclusionAround four in every 10 pregnant women had thyroid disorder. Thyroid dysfunction is easily detectable and can be effectively, inexpensively treated, which can prevent adverse maternal and foetal outcome. Thus, we should consider universal screening of pregnant women for thyroid disorder especially in a country like Nepal where there is a high prevalence of undiagnosed thyroid disorder.

HIV Prevention Tools Across the Pregnancy Continuum: What Works, What Does Not, and What Can We Do Differently?

Multiple tools exist to support the primary prevention of HIV in pregnant and postpartum women; however, there are opportunities to enhance their use and impact. This review summarizes the current status of HIV prevention tools and existing gaps and opportunities to improve their use along the pregnancy care continuum. HIV screening efforts have steadily improved with close to universal screening of pregnant women in several East and Southern African countries. Strategies to implement partner testing through the distribution of HIV self-test kits are promising though linkage to care remains challenging. Syphilis screening rates are increasing though detection of other sexually transmitted infections could benefit from improved diagnostic capacity. Male and female condoms are rarely used and are often not the optimal tool of choice during pregnancy. Oral pre-exposure prophylaxis (PrEP) is a promising tool, although barriers such as the need for daily adherence, side effects, and stigma may limit its use. There is a growing pipeline of PrEP agents with alternative delivery platforms that might suit women's preferences better and supports the notion that choice is vital to improving HIV prevention coverage during the pregnancy-postpartum continuum. Clear guidance on which tools to use and how to use them, safety data supporting their use, and surveillance data documenting the scale and effectiveness of the tools will be imperative in establishing a path to more impactful prevention efforts among pregnant and postpartum women.

Sepsis and Streptococcus agalactiae meningitis in a 3-month-old boy

Streptococcus agalactiae bacteria are a common cause of neonatal sepsis and meningitis. Universal screening of pregnant women for carriage and intrapartum antibiotic prophylaxis has significantly reduced the disease prevalence in children up to 7 days of age. However, it is to be remembered that group B streptococcal infection can also affect older children, even if their mothers have tested negative for Streptococcus agalactiae during pregnancy or underwent complete perinatal antibiotic prophylaxis. This paper presents a clinical case of a 3-month-old boy treated for sepsis and Streptococcus agalactiae meningitis. The baby was born on time, with normal body weight. The infection occurred despite full maternal ampicillin perinatal therapy in the mother.

PREVALENCE OF SUBCLINICAL HYPOTHYROIDISM AND ITS FOETO-MATERNAL OUTCOME IN SUBHIMALAYAN PREGNANT WOMEN

Background: Thyroid disorders are the most common endocrinopathies encountered during pregnancy in India. Thyroid gland and its functions are immensely influenced by pregnancy. This study was designed to evaluate the prevalence of subclinical hypothyroidism in pregnancy and its foeto-maternal outcome amongst the pregnant mothers having such disorder. Methods: In this hospital based, observational, comparative study, which was carried out on 200 pregnant women attending secondary care hospital of subhimalayan region for the duration of 1 year (2017 to 2018).Morning blood samples of study participants were analyzed for free T4, TSH in their first trimester, and they were followed up till the time of confinement for foeto-maternal outcome. Results: prevalence of thyroid disorder was 16% which was high as compare to other regions of India. Subclinical hypothyroidism was highly prevalent (13.5%) and masked, associated with adverse maternal outcomes like anaemia (p=0.001), abortion (p=0.012), postpartum haemorrhage (p=0.012), puerperal sepsis (p=0.008) and adverse foetal outcome like foetal growth restriction (p=0.034) as compared to euthyroidism. Conclusion: In a developing country like India where undiagnosed thyroid disorders especially subclinical hypothyroidism is highly prevalent and associated with adverse foeto-maternal outcomes, our study recommends universal screening of pregnant women for such disorders.

Pregnancy and Viral Hepatitis: Current Concepts.

Viral hepatitis in pregnancy constitutes a complex issue, requiring meticulous management due to the potential potent compromise of both mother's and fetus' health. Hepatitis B and C are implicated with a high risk for chronicity, whereas hepatitis A and hepatitis E have an acute course. In pre-existing viral disease, pregnancy may lead to exacerbation of the disease's course due to a plethora of hormonal, immunological and genetic alterations. Vice versa, viral hepatitis, acute or chronic, during pregnancy, can cause gestational complications that may lead to significant maternal and neonatal morbidity and mortality. Mother to child transmission of hepatitis B and C virus, in high prevalence areas, has been recognized as a major cause of chronic viral infection and related complications in children. Due to the physiologic alterations in pregnancy, therapeutic indications may differ from those in the general population and there is an expanding field of research on available drugs and vaccines efficacy and safety during pregnancy. Of utmost importance remains the implementation of a preventive strategy in order to reduce the rates of vertical transmission. Universal screening of pregnant women, assessing the risk of transmission and determining the mode of delivery and the impact of breastfeeding are crucial aspects of this strategy. This review summarizes the impact of viral hepatitis in pregnancy, strategies of prevention of vertical transmission and available treatments.

Enhancing Electronic Health Systems to End Transmission of Chronic Hepatitis B During COVID-19: A Collaborative Approach.

Enhancing Electronic Health Systems to End Transmission of Chronic Hepatitis B During COVID-19: A Collaborative Approach.

Poor Adherence to the Screening-Based Strategy of Group B Streptococcus Despite Colonization of Pregnant Women in Greece.

Group B streptococcus (GBS) is a leading cause of serious neonatal infections. Maternal GBS colonization is associated with early- and late-onset neonatal disease (EOD/LOD). In Greece, a screening-based strategy is recommended, in which concurrent vaginal-rectal cultures should be obtained between 36 0/7 and 37 6/7 weeks’ gestation. We sought to examine the level of adherence to the GBS screening guidelines and estimate the prevalence of GBS colonization among pregnant women. Although in Greece the screening-based strategy is followed, we also examined known EOD risk factors and linked them to GBS colonization. A cross-sectional study of 604 women postpartum in three hospitals and maternity clinics was conducted. Following written informed consent, data were collected via a short self-completed questionnaire and review of patients’ records. In 34.6% of the enrolled pregnant women, no culture had been taken. Of the remaining, 12.8% had proper vaginal-rectal sample collections. The overall maternal colonization rate was 9.6%. At least one risk factor for EOD was identified in 12.6% of participants. The presence of risk factors was associated with positive cultures (p = 0.014). The rate of culture collection did not differ between women with or without an EOD risk factor. Adherence to a universal screening of pregnant women with vaginal-rectal cultures was poor. Despite probable underestimation of GBS carrier status, almost 1 in 10 participants were GBS positive during pregnancy. Screening of women with risk factors for EOD should, at least, be prioritized to achieve prevention and prompt intervention of EOD.

Universal Sars-Cov-2 Screening in Pregnant Women: Experience from the Italian Epidemic Outbreak.

Background and aim:Sars-CoV-2 infection has rapidly spread worldwide following the first cases reported in China. Piacenza is one of the most affected cities in Italy. Many infections occurred in the hospital due to the high frequency of patients and healthcare professionals interaction. The aim of the work is to evaluate advantages of universal screening for Sars-Cov-2 in pregnant women admitted to a hospital setting and calculate frequency of infection in an obstetrical population.Methods:all pregnant women attending Guglielmo da Saliceto Hospital in Piacenza from 22nd April to 18th June 2020 were screened for Sars-Cov-2 using a nasopharyngeal swab.Results:240 pregnant women were tested upon admission: all twelve (5%) testing positive were asymptomatic. None of the positive asymptomatic women developed COVID-19 symptoms or adverse perinatal outcomes.Conclusions:the diagnosis of asymptomatic pregnant women through universal screening provides the opportunity to protect mothers, babies and heath care workers. In accordance with other studies, our findings add to the growing body of evidence showing high rates of asymptomatic infection in the healthcare setting and highlight a critical need for universal screening of pregnant women. (www.actabiomedica.it)

The Increased Prevalence of Thyroid Dysfunction in First Trimester Pregnancy in a Tertiary Care Centre and the Significance of Universal Screening

Introduction: Thyroid disorder is the second most common endocrine disorder in pregnancy, after diabetes. The present study was designed to assess the prevalence of thyroid disorder in first trimester in pregnant women in a tertiary care centre. Materials and Methods: This was a descriptive cross sectional study in which thyroid hormone levels and Anti- TPO antibodies levels were measured in one hundred and forty two pregnant women. The analytes were measured using Cobas e 411 autoanalyzer which is based on ECLIA principle. Results: From our study we found that 51.4% of the pregnant women had thyroid dysfunction. 40.9% of the pregnant women were found to have subclinical hypothyroidism with high TSH levels but normal FT4 levels. Hypothyroidism is diagnosed to be much more common that hyperthyroidism in pregnant women. In addition, 10.5% of our study population was found to have autoantibodies to thyroid peroxidase enzyme. Conclusion: The increased prevalence of thyroid disorders makes it necessary to start universal screening of pregnant women for thyroid disorders which would help in the early identification and rectification of thyroid disorders in pregnant women. Further, early screening and treatment of thyroid disorders would prevent to a large extent the incidence of thyroid disorders in the newborns, which is one of the leading causes of mental retardation.

Prevalences of subclinical and overt hypothyroidism with universal screening in early pregnancy.

To reveal the prevalence of subclinical and overt hypothyroidism among Turkish population during pregnancy. Also to investigate the prevalence of hypothyroidism using ATA 2017 criteria. This is a cross-sectional study. Patients were consisted of 1416 consecutive pregnant women who were universally screened for thyroid disease in their first trimester between 2013 and 2015. Thyroid-stimulating hormone (TSH) and free T4 (FT4) levels were analyzed during the first antenatal visit (before 12weeks of gestation). We compared different cutoffs for TSH. We further determined the 2.5th and 97.5th percentiles for TSH and FT4. Initially, the cutoff of 2.5IU/ml was selected. Accordingly, 305 women (22.3%) had subclinical hypothyroidism and 22 (1.6%) was diagnosed with overt hypothyroidism. When the cutoff was increased to 4IU/ml, only 40 (2.9%) women were diagnosed with hypothyroidism. Prevalences of overt hypothyroidism and subclinical hypothyroidism were 0.6% and 2.3%, respectively. Universal screening of pregnant women with TSH, using the 2.5mIU/L cutoff; one in four women was found to be a candidate for thyroid hormone replacement in our cohort. When the cutoff was determined to be 4mIU/L, prevalence of hypothyroidism decreased approximately 10 times.

Hepatitis C Virus Infection in Children and Pregnant Women: An Updated Review of the Literature on Screening and Treatments

Objective The aim of the paper is to review the current information relating to the diagnosis and treatment of hepatitis C virus (HCV) infection in pregnant women and children, particularly those infected by mother-to-child transmission. Study Design A review of published literature was performed to identify relevant articles published between January 2015 and March 2019 on: HCV infection in pregnant woman, mother-to child-transmission of HCV and HCV infection in pediatrics. The results of the evaluation of the different studies were summarized in two sections describing separately the screening and effective treatments in pregnant women and children. Results The rate of mother-to-child transmission of HCV is approximately 5%. HCV infection is strongly associated with cholestasis and preterm birth. Prenatal diagnosis of hepatitis C virus has a dual benefit for mother and child. Perinatally infected children develop cirrhosis in earlier age than those who acquire HCV as adolescents. Pregnant women with cirrhosis have a higher risk of poor maternal and neonatal outcomes than those without cirrhosis. Conclusion To improve public health, universal screening of pregnant women for HCV infection should be performed. Early identification of women and children with HCV infection is important to enable them to be included in assessment and/or treatment programs.

Testing for Hepatitis C in Pregnancy: the Time has Come for Routine Rather than Risk-based.

The purpose of this review is to discuss the reasons for HCV testing during pregnancy and to review what is known about antiviral treatment during pregnancy. Hepatitis C virus affects over 3 million persons in the United States and is one of the leading infectious causes of death. While HCV is most commonly transmitted via parenteral exposures, thus affecting people who inject drugs, it is also transmitted from mother-to-child. Due to an expanding opioid crisis, an increasing number of women of childbearing age are now infected, resulting in transmission to infants. Risk-based screening has never been proven effective and thus universal screening of pregnant women for HCV infection has been recommended. Obstetricians may play a key role in the U.S. by implementing universal testing for HCV in pregnant women, thereby enhancing the health of mothers and identifying children at risk.

Compliance with screening for and recommended management of maternal group B streptococcus carriage in pregnancy.

Universal screening of pregnant women at 35-37weeks gestation is recommended for detection of anogenital group B streptococcus carriage. Intrapartum chemoprophylaxis is prescribed to carriers to prevent transmission to babies, reducing early-onset neonatal group B streptococcal sepsis. To review compliance with, and the effects of education on group B streptococcus screening and intrapartum chemoprophylaxis practices at The Royal Women's Hospital, Melbourne, Australia. A retrospective audit of women delivering in February 2016 and February-March 2017 was conducted. In February 2017, updated early-onset group B streptococcal disease prevention guidelines were released and promoted with targeted education of clinical staff. Compliance was considered appropriate if practices followed up-to-date local protocols. Screening rate for group B streptococcus was 84.4% (599/710) and carriage rate 19.5% (109/558), while intrapartum antibiotic prophylaxis was optimal in 83% of those labouring greater than four hours (39/47). There was no significant difference in compliance between 2016 and 2017. Of 113 women with unknown group B streptococcal status at delivery, only five of 33 (15%) with clinical risk factors for early-onset neonatal disease received intrapartum prophylaxis. Compliance remained stable, with no change during or after implementation of new protocols. Compliance with protocols was low for cases with unknown group B streptococcal status at delivery but with the presence of one or more clinical risk factors for early-onset group B streptococcal sepsis.

Prevalence of Streptococcus agalactiae colonization in pregnant women from the 18th Health Region of Paraná State.

ABSTRACTIntroduction The aim of this study was to determine the prevalence of GBS colonization in pregnant women in a public health service.Methods A study of 496 pregnant women at 35-37 gestational weeks was conducted from September 2011 to March 2014 in 21 municipalities of the 18th Health Region of Paraná State. Vaginal and anorectal samples of each woman were plated on sheep blood agar, and in HPTH and Todd-Hewitt enrichment broths.Results Of the 496 pregnant women, 141 (28.4%) were positive for GBS based on the combination of the three culture media with vaginal and anorectal samples. The prevalence was 23.7% for vaginal samples and 21.9% for anorectal ones. Among the variables analyzed in this study, only urinary infection was a significant factor (0.026) associated with GBS colonization in women.Conclusions Based on these results, health units should performs universal screening of pregnant women and hospitals should provide adequate prophylaxis, when indicated.

The prevalence and risk factors for Trichomonas vaginalis infection amongst human immunodeficiency virus-infected pregnant women attending the antenatal clinics of a university teaching hospital in Lagos, South-Western, Nigeria.

Trichomonas vaginalis infection is the most prevalent non-viral sexually transmitted infection worldwide. Interactions between this infection and human immunodeficiency virus (HIV) may cause adverse pregnancy outcomes such as preterm labour, premature rupture of membranes, chorioamnionitis, low birth weight and post-abortal sepsis. This study was aimed to determine the prevalence and risk factors of T. vaginalis infection amongst HIV-positive pregnant women attending antenatal care at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. This was an analytical cross-sectional study in which 320 eligible participants which included 160 HIV-positive (case group) and 160 HIV-negative (control group) pregnant women were recruited at the antenatal clinic of LUTH. A structured pro forma was used to collect data from consenting participants after which high vaginal swabs were collected, processed and examined for T. vaginalis. The association between categorical variables was tested using the Chi-square test and Fisher's exact test where applicable. All significances were reported at P < 0.05. The prevalence of T. vaginalis infection amongst HIV-positive and HIV-negative pregnant women were 10% and 8.1%, respectively (P = 0.559). Significant risk factors for T. vaginalis infection in the HIV-positive pregnant women were early coitarche (P < 0.005) and multiple lifetime sexual partners (P = 0.021). There was no relationship between the T. vaginalis infection and the immunological markers of HIV infection. While this study does not provide grounds for universal screening of pregnant women for T. vaginalis infection as a tool of reducing HIV acquisition, especially in pregnancy, campaign to create better sexual health awareness should be commenced as a way to contributing to the reduction in T. vaginalis infection during pregnancy and perinatal transmission of HIV.

Prevalence of Gestational Diabetes Mellitus and its association with pregnancy outcomes in three referral hospitals in Bhutan

Introduction: Gestational Diabetes Mellitus (GDM) has been defined as any degree of glucose intolerance with onset or first recognition during pregnancy. There is no national data on the prevalence of gestational diabetes mellitus, and there is no routine screening system for diabetes in pregnancy in Bhutan. This study was carried out to determine the prevalence of GDM and its association with pregnancy outcomes in three referral hospitals in Bhutan.&#x0D; Methods: This was a prospective study done between March and December 2016 in three referral hospitals in Bhutan, with 726 participants recruited between 24 to 28 weeks of pregnancy. Two blood samples were taken, one in a fasting state to test fasting blood sugar and another to test blood sugar level 2 hours after drinking 75g glucose in 300ml water. They were analyzed in the Clinical Biochemistry laboratories in the respective hospitals. Cut-off levels of 5.6mmol/ L (101mg/ dL) for fasting blood sugar and 8.5-mmol/L (153-mg/dL) for 2 hours blood sugar report were used. Women diagnosed with GDM were closely followed up throughout the pregnancy up till delivery. At delivery, information on mother and the baby were collected.&#x0D; Results: The prevalence of GDM in the three referral hospitals in Bhutan was 15%. The prevalence of GDM cases in the three hospitals was similar and statistically was not significant. Conclusions: Universal screening of pregnant women is recommended to detect hyperglycemia and to achieve euglycemia in order to prevent complications in both mothers and babies.

Periconceptional CMV infection prevention in Portugal: population subgroup study in a tertiary perinatal care center

Currently in Portugal, universal screening of pregnant women for Cytomegalovirus (CMV) infection is not performed. However, it is recommended to screen all women attending preconception care. We aimed to assess women’s attendance to preconception care and if their serologic status regarding CMV was known and/or investigated in that consultation. In this cross-sectional study, we interviewed 240 women admitted to the obstetrical ward of a hospital in the Metropolitan Area of Porto (Portugal) about their adherence to preconception care and collected data regarding their CMV serologic status and its investigation. We found that 71.3% of the women who attended preconception care were not screened for CMV infection. Among primigravida, the screening rate was only of 30.4% (upper limit of CI 95%: 44.8%). There were no statistically significant differences between the private and public sectors of healthcare. We observed attendance to preconception care is high (73.1%). For the population subgroup of the metropolitan area of Porto, attendance to preconception care is at least 66%, with a 95% confidence level. Portuguese guidelines stating a woman’s serologic status regarding CMV should be investigated in preconception care are not properly implemented. This suggests guidelines should assure the screening of previously non-screened women during pregnancy.

Making the Case for Universal Screening of Pregnant Women for Hepatitis C Virus: One State at a Time

Background New cases of Hepatitis C virus (HCV) infection are climbing in young adults and particularly in women of child-bearing age. Despite this growing burden, a risk-based screening approach is still recommended when testing for HCV in pregnant women and young adults. Risk-based screening was abandoned for “Baby Boomer” adults in favor of universal screening due to concerns for insufficient capture of cases.Objective. We analyzed public health department data for all 50 states to compare the published rates of HCV infection among young adults and Baby BoomersMethods Public health department websites for all 50 states were reviewed for the most recent information on HCV incidence and prevalence. Age-specific rates were recorded for young adults (ages 20–39) compared with Baby Boomers (ages 50–70). When specific rates were not available, data on year over year trends were noted for both age groups.ResultsUsing their own published data, we identified 11 states where rates of HCV infection in young adults surpassed that of Baby Boomers, and 4 states where the rates of HCV were equal between the 2 age groups. These states alone make-up 25% of the entire US population. When we include 6 additional highly populous states with reported HCV incidence on the rise in young adults, these 21 states account for more than half the US population. Only 4 states reported HCV rates in Baby Boomers to be higher than young adults and 25 states had no recent data to review. Of note, most of these states are direct neighbors to states in the first 2 categories with a higher burden of HCV.Conclusion Even using a risk-based screening strategy with lower case capture rate in young adults compared with universal screening in Baby Boomers, we identified that many states have HCV rates in young adults that is as high or higher than Baby Boomers. These results suggest that universal screening in this age group is warranted, where DAA treatment could reduce future spread. Pregnant women represent an easy group to target given their frequent medical visits, frequent lab testing, their exposed infants would require follow-up testing and the women could be referred for DAA treatment after delivery.Disclosures R. Jhaveri, Gilead: Grant Investigator, Grant recipient. Abbvie: Grant Investigator, Grant recipient. Merck: Grant Investigator, Grant recipient

Factors Associated with Hepatitis B Surface Antigen Seropositivity among Pregnant Women in Kigali, Rwanda: A Cross Sectional Study

Background: Hepatitis B virus (HBV) is the commonest cause of chronic viral hepatitis which is responsible for up to 80% of primary liver cancers. Pregnant women who are carriers of the virus pose a significant risk to their health and unborn babies. Majority of countries in developing world have not yet adopted universal screening for pregnant women. Therefore, this study aimed at determining the prevalence and associated risk factors of hepatitis B surface antigen (HBsAg) among pregnant women in Kigali. Methods: A multicenter, facility based cross-sectional study was conducted on 385 pregnant women visiting antenatal care between May and August 2013. Data on socio-demographic information and possible risk factors of HBV were collected using a pretested structured questionnaire. Blood samples were collected for the detection of HBsAg using a standard diagnostics INC Bioline HBsAg test device followed by confirmatory ELISA for the positive samples. The results were analyzed using descriptive statistics and binary logistic regression. Crude and adjusted odds ratios with corresponding 95% confidence interval (CI) were calculated. A p-value of less than 0.05 was considered significant. Results: Of the 385 pregnant women enrolled in this study, 3.1% (95% CI=1.4% to 4.8%) were found to be seropositive for HBsAg. Pregnant women who ever worked in hospital (AOR=12.7; 95% CI=2.21-72.57; P=0.004) and had history of gestational diabetes (AOR=10.9; 95% CI=1.87-63.52; P=0.008) were independently associated with HBsAg seropositivity. Though, history of HBV infection in family member was significantly associated during bivariate analysis, it was insignificant in multivariable analysis. Conclusion: This study indicates that Kigali has intermediate endemicity of HBV among pregnant women. Considering the severity of the infection, HBV is important public health issue in the study area that needs to be addressed. Universal and free ante-natal screening and/or vaccination should be adopted. Moreover, awareness and vaccination coverage to be expanded for healthcare staff, gestational diabetes and family contacts of infected individuals.

Assessment of State Perinatal Hepatitis B Prevention Laws.

Identifying pregnant women with hepatitis B virus (HBV) infection for post-exposure prophylaxis of their infants is critical to preventing mother-to-child transmission of HBV infection. HBV infection in infancy results in premature death from chronic liver disease or cancer in 25% of affected infants. Universal screening of pregnant women for HBV infection is the standard of care, and in many states is supported by laws for screening and reporting these infections to public health. No recent assessment of state screening and reporting laws for HBV infection has been published. In 2014, the authors analyzed laws current through December 31, 2013 from U.S. jurisdictions (50 states and the District of Columbia) related to HBV infection and hepatitis B surface antigen screening and reporting requirements generally and for pregnant women specifically. All states require reporting of cases of HBV infection. Twenty-six states require pregnant women to be screened. Thirty-three states require public health reporting of HBV infections in pregnant women, but only 12 states require reporting pregnancy status of women with HBV infection. This assessment revealed significant variability in laws related to screening and reporting of HBV infection among pregnant women in the U.S. Implementing comprehensive HBV infection screening and reporting laws for pregnant women may facilitate identifying HBV-infected pregnant women and preventing HBV infection in their infants.