Mothers with hepatitis B should stabilize their condition before getting pregnant, and preventive measures against mother-to-child transmission should be taken before and after childbirth. Mother-to-child transmission is one of the important ways that the hepatitis B virus spreads; most carriers in previous years were infected through mother-to-child transmission. Studies have shown that without intervention measures, about 40% of infants born to mothers who are HBsAg positive will test positive for HBsAg within six months. For infants born to mothers who are both HBsAg and HBeAg positive, the rate of HBsAg positivity can exceed 90%.
During delivery, mothers with high levels of hepatitis B (HBeAg positive) may transmit the virus vertically through the placenta at a rate exceeding 80%. Therefore, within 24 hours of birth (preferably within 6 hours), newborns should be injected with high-titer hepatitis B immunoglobulin and a hepatitis B vaccine (30 micrograms). Subsequently, two more injections (each 30 micrograms) should be given according to the prescribed schedule. If the health condition of the hepatitis B-infected mother is good, breastfeeding may be possible. After the child reaches one year old, an additional hepatitis B vaccine injection (10-30 micrograms) should be administered.
Delta hepatitis often co-infects with hepatitis B, either simultaneously or as a superinfection on top of hepatitis B. Pregnant women who contract delta hepatitis, or who are co-infected with hepatitis B, are more likely to experience miscarriage, premature birth, stillbirth, postpartum hemorrhage, severe hepatitis, or hepatic coma. In such cases, pregnancy should be terminated as early as possible.
What measures should mothers with hepatitis B take?
1. Aggressive antiviral treatment: The level of HBV-DNA in the pregnant woman's body is crucial in affecting the chance of transmission. Therefore, before becoming pregnant, hepatitis B should be actively treated to lower serum HBV-DNA levels, thereby minimizing vertical transmission from mother to child.
2. Strictly enforce disinfection and isolation protocols, use dedicated delivery beds, prevent birth canal damage and neonatal injuries, and avoid inhalation of amniotic fluid. Breastfeeding should be prohibited, and the infant should be formula-fed (milk or powdered milk).
3. Immediate combined immunization for the newborn: Within 6 hours of birth, the newborn should be injected with high-titer hepatitis B immunoglobulin (HBIG) 0.5 milliliters. Additional doses of 0.16 milliliters per kilogram body weight should be given at one month and two months after birth to provide passive immunity. Additionally, the newborn should receive a hepatitis B vaccine injection of 30 micrograms within 24 hours of birth, at two months, and at six months.
4. Postnatal interruption: Although breastfeeding is the best feeding method, there is no consensus on whether chronic hepatitis B mothers should breastfeed. Most experts believe that breastfeeding by mothers who are hepatitis B surface antigen positive does not increase the risk of infant infection. Therefore, if the newborn receives hepatitis B immunoglobulin and a hepatitis B vaccine within 12 hours of birth, breastfeeding can proceed. However, for mothers with very high HBV-DNA levels in their blood or breast milk, cracked nipples, or infants with oral mucosal ulcers or skin damage around the mouth, even if the infant has received combined immunization with HBIG and the hepatitis B vaccine, breastfeeding should ideally be avoided.
Experts from the PLA 463 Hospital remind that when pregnant, women with hepatitis B should choose a regular liver disease hospital and follow expert guidance to ensure their own safety and the health of their children. The PLA 463 Hospital is the only hospital in Liaoning Province, China, qualified to conduct "cell-peptide immune therapy" and currently offers this service to the public. For questions regarding precautions for mothers with hepatitis B, you can directly click on online consultation or call the liver disease expert hotline at 024-86222463, where authoritative experts from the PLA 463 Hospital will answer your questions.