Essentials of immunoprophylaxis against hepatitis B in newborns

Immunoprophylaxis points for neonatal hepatitis B include the following. ① Pregnant women need to be tested for HBV serological markers prenatally: HBsAg positive indicates HBV infection and is infectious; HBeAg positive is highly infectious; anti-HBs positive is immune to hepatitis B. ② pregnant women HBsAg negative: newborns in accordance with the 0-1-6 months (within 24h, 1 month and 6 months) 3 injection program for hepatitis B vaccine; do not have to inject HBIG. ③ pregnant women HBsAg positive: newborns within 12h of birth must be intramuscular injection of HBIG; at the same time in accordance with the 0-1-6 months of the 3 injection program for hepatitis B vaccine. Breastfeeding in HBsAg-positive pregnant women: after taking regular preventive measures for the newborn, breastfeeding is feasible regardless of whether the pregnant woman is HBeAg-positive or not. ⑤ Mode of delivery and mother-to-child transmission: Cesarean section delivery cannot reduce the rate of mother-to-child transmission of HBV. (6) Hepatitis B vaccination for preterm infants: if the body mass at birth is ≥2000g, it will be treated as normal; if <2000g, the first vaccine will be injected when the body mass reaches 2000g, and then the vaccine will be given at an interval of 1 month according to the 3-dose program of 0-1-6 months. If the pregnant woman is HBsAg negative and the preterm baby is in good health, the baby will be vaccinated according to the above program; if the baby is not in good health, the baby will be treated for the relevant diseases first and then vaccinated after recovery. Pregnant women with positive HBsAg, regardless of the health status of preterm infants, HBIG should be injected intramuscularly within 12h, and then injected again after an interval of 3~4 weeks, and the newborns should be vaccinated once within 24h, 3~4 weeks, 2~3 months, and 6~7 months of age, and be followed up. (vii) Whether HBsAg-positive pregnant women should be treated with anti-HBV therapy to reduce the rate of mother-to-child transmission: pregnant women who are HBeAg-negative do not need antiviral therapy; if they are HBeAg-positive, whether they should be treated with anti-HBV therapy has yet to be confirmed by rigorous multicenter controlled studies. If other family members are HBsAg-positive and participate in puerperal care, the newborn must be injected with HBIG. ⑧ Neonatal follow-up of HBsAg-positive pregnant women: HBV serologic markers are tested in the newborn at 7 to 12 months of age. If their HBsAg is negative, anti-HBs is positive, it means that the vaccination is successful, resistance; if HBsAg, anti-HBs are negative, it means that the prevention of vaccination is successful, but need to be consolidated with another 3 shots of vaccine; if HBsAg positive, it means that the prevention of failure, has been transformed into a chronic HBV-infected patients. ⑨ Other precautions: Before performing any operation on the newborn that damages the skin and mucous membranes, the newborn must be adequately cleaned and sterilized before proceeding. Pre-eclamptic mothers with hepatitis B, should pay attention to the function of the liver, the newborn does not need special requirements for immunization.