Proposal for routine antenatal screening at 14 weeks for hepatitis B surface antigen. Dutch Study Group on Prevention of Neonatal Hepatitis.
P M Grosheide
J W Wladimiroff
R A Heijtink
J A Mazel
G C Christiaens
A S Nuijten
S W Schalm
Abstract
OBJECTIVE--To develop a low cost, high compliance screening programme for identification of carriers of hepatitis B surface antigen in the obstetric population of the Netherlands. DESIGN--A seven year open, descriptive study of screening for hepatitis B surface antigen as part of routine prenatal laboratory testing at 14 weeks of gestation. Compliance with programme evaluated by checking delivery records (hospitals) or registration of births in the 30 participating municipalities (rural area). SETTING--Three large city hospitals (two tertiary referral centres) and one rural area with a large number of home deliveries. SUBJECTS--99,706 pregnant women applying for prenatal care for the first time. MAIN OUTCOME MEASURES--Proportion of pregnant women routinely screened; prevalence of hepatitis B surface antigen in large cities and rural area. RESULTS--Uptake of screening reached 97% in the hospitals after inclusion of 10% screened at delivery; the estimated uptake in the rural area was > 95%. Prevalence of hepatitis B surface antigen was 1.6% in the large cities and 0.3% in the rural area. For screening at delivery the prevalence was 2.5 times higher (4%, P < 0.01) than for screening at week 14 of gestation. CONCLUSION--Incorporation of universal testing for hepatitis B surface antigen into routine prenatal laboratory testing is practical; high compliance is achieved when screening is supplemented with rapid screening at delivery for those who escaped routine prenatal care.
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Selected References
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- Arevalo J. A., Washington A. E. Cost-effectiveness of prenatal screening and immunization for hepatitis B virus. JAMA. 1988 Jan 15;259(3):365–369. [PubMed] [Google Scholar]
- Beasley R. P., Hwang L. Y., Stevens C. E., Lin C. C., Hsieh F. J., Wang K. Y., Sun T. S., Szmuness W. Efficacy of hepatitis B immune globulin for prevention of perinatal transmission of the hepatitis B virus carrier state: final report of a randomized double-blind, placebo-controlled trial. Hepatology. 1983 Mar-Apr;3(2):135–141. doi: 10.1002/hep.1840030201. [DOI] [PubMed] [Google Scholar]
- Francis D. P. Worldwide control of hepatitis B virus: an approaching reality? Pediatrics. 1985 Nov;76(5):851–852. [PubMed] [Google Scholar]
- Greenspoon J. S., Martin J., Greenspoon R. L., McNamara B. T. Necessity for routine obstetric screening for hepatitis B surface antigen. J Reprod Med. 1989 Sep;34(9):655–658. [PubMed] [Google Scholar]
- Grosheide P. M., del Canho R., Heijtink R. A., Nuijten A. S., Zwijnenberg J., Bänffer J. R., Wladimiroff Y. W., Botman M. J., Mazel J. A., de Gast G. C. Passive-active immunization in infants of hepatitis Be antigen-positive mothers. Comparison of the efficacy of early and delayed active immunization. Am J Dis Child. 1993 Dec;147(12):1316–1320. doi: 10.1001/archpedi.1993.02160360058019. [DOI] [PubMed] [Google Scholar]
- Ip H. M., Lelie P. N., Wong V. C., Kuhns M. C., Reesink H. W. Prevention of hepatitis B virus carrier state in infants according to maternal serum levels of HBV DNA. Lancet. 1989 Feb 25;1(8635):406–410. doi: 10.1016/s0140-6736(89)90003-2. [DOI] [PubMed] [Google Scholar]
- Jonas M. M., Schiff E. R., O'Sullivan M. J., de Medina M., Reddy K. R., Jeffers L. J., Fayne T., Roach K. C., Steele B. W. Failure of Centers for Disease Control criteria to identify hepatitis B infection in a large municipal obstetrical population. Ann Intern Med. 1987 Sep;107(3):335–337. doi: 10.7326/0003-4819-107-2-335. [DOI] [PubMed] [Google Scholar]
- Maupas P., Chiron J. P., Barin F., Coursaget P., Goudeau A., Perrin J., Denis F., Mar I. D. Efficacy of hepatitis B vaccine in prevention of early HBsAg carrier state in children. Controlled trial in an endemic area (Senegal). Lancet. 1981 Feb 7;1(8215):289–292. doi: 10.1016/s0140-6736(81)91908-5. [DOI] [PubMed] [Google Scholar]
- Mazel J. A., Schalm S. W., de Gast B. C., Nuijten A. S., Heijtink R. A., Botman M. J., Bänffer J. R., Gerards L. J., Zwijnenberg J., Mettau J. Passive-active immunisation of neonates of HBsAg positive carrier mothers: preliminary observations. Br Med J (Clin Res Ed) 1984 Feb 18;288(6416):513–515. doi: 10.1136/bmj.288.6416.513. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schalm S. W., Mazel J. A., de Gast G. C., Heijtink R. A., Botman M. J., Bänffer J. R., Cerards L. J., Zwijnenberg J., Fetter W. P., Nuijten S. M. Prevention of hepatitis B infection in newborns through mass screening and delayed vaccination of all infants of mothers with hepatitis B surface antigen. Pediatrics. 1989 Jun;83(6):1041–1048. [PubMed] [Google Scholar]
- Silverman N. S., Darby M. J., Ronkin S. L., Wapner R. J. Hepatitis B prevalence in an unregistered prenatal population. Implications for neonatal therapy. JAMA. 1991 Nov 27;266(20):2852–2855. [PubMed] [Google Scholar]
- Tada H., Yanagida M., Mishina J., Fujii T., Baba K., Ishikawa S., Aihara S., Tsuda F., Miyakawa Y., Mayumi M. Combined passive and active immunization for preventing perinatal transmission of hepatitis B virus carrier state. Pediatrics. 1982 Oct;70(4):613–619. [PubMed] [Google Scholar]
- Wainwright R. B., McMahon B. J., Bender T. R., Heyward W. L., Nakanishi S., Wainwright K. Y., Foliaki S., Erickson S. L., Fields H. A. Prevalence of hepatitis B virus infection in Tonga: identifying high risk groups for immunization with hepatitis B vaccine. Int J Epidemiol. 1986 Dec;15(4):567–571. doi: 10.1093/ije/15.4.567. [DOI] [PubMed] [Google Scholar]
- del Canho R., Grosheide P. M., Schalm S. W., de Vries R. R., Heijtink R. A. Failure of neonatal hepatitis B vaccination: the role of HBV-DNA levels in hepatitis B carrier mothers and HLA antigens in neonates. J Hepatol. 1994 Apr;20(4):483–486. doi: 10.1016/s0168-8278(05)80494-5. [DOI] [PubMed] [Google Scholar]