Clinical guidelines for prevention of mother-to-child transmission of hepatitis B

The Obstetrics and Gynecology Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association issued clinical guidelines for the prevention of mother-to-child transmission of hepatitis B virus in July 2013, the main points of which are as follows: 1. All pregnant women need to be tested for hepatitis B serological markers before delivery. 2. HBsAg-negative pregnant women: newborns are vaccinated with hepatitis B vaccine according to the 3-dose regimen at 0, 1 and 6 months, and no further HBIG is necessary. 3. HBsAg-positive pregnant women: newborns are given one intramuscular injection of HBIG within 12 hours of birth, along with hepatitis B vaccine according to the 3-dose regimen at 0, 1 and 6 months. 4.Breastfeeding for HBsAg-positive pregnant women: after formal prevention of the newborn, breastfeeding is feasible regardless of whether the pregnant woman is HBeAg negative or positive. 5, mode of delivery and mother-to-child transmission: cesarean delivery cannot reduce the rate of mother-to-child transmission of HBV. 6, preterm infants: no special treatment is needed when the birth mass reaches or exceeds 2000g. If the body mass is less than 2000g, the first dose of vaccine should be injected after the body mass reaches 2000g, and then after an interval of 1-2 months, the 3-dose program should be implemented according to 0, 1 and 6 months. If the pregnant woman is HBsAg negative and the premature baby is in good health, treat as above; if the health condition is not good, treat the related disease first and wait for recovery before vaccination. If the pregnant woman is HBsAg positive, regardless of the health condition of the premature baby, one injection of HBIG will be given intramuscularly within 12 hours, and another injection will be required after an interval of 3-4 weeks; vaccination will be given within 24 hours of birth, 3-4 weeks, 2-3 months and 6-7 months, and follow-up will be conducted. 7. Other family members HBsAg positive: If the newborn is in close contact with HBsAg positive members, HBIG must be injected, but not in close contact, no injection is necessary. 8. Follow-up of newborns of HBsAg-positive pregnant women: at 7-12 months, test for serological markers of hepatitis B. If HBsAg negative and anti-HBs positive, prevention is successful and resistant; if HBsAg negative and anti-HBs negative, prevention is successful but requires another 3 doses of vaccination program; if HBsAg positive, prevention fails and becomes chronic infected. 9, other precautions: before any operation that damages the skin mucosa, it must be fully cleaned and disinfected before proceeding. 10, HBsAg-positive pregnant women whether to perform anti-HBV treatment to reduce the rate of mother-to-child transmission: HbeAg negative, no antiviral; HbeAg positive, whether anti-HBV treatment should be inconclusive, requiring rigorous multi-center controlled studies. 11, HBV-infected pregnant women do not need to apply HBIG in late pregnancy.