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Iowa Neonatology Handbook: Infection
Hepatitis B
Charles Grose, MD
Peer Review Status: Internally Peer
Reviewed
Mothers are routinely tested for the Hepatitis B surface antigen
(HBsAg) status during their pregnancy. There is a risk of both
vertical perinatal transmission to the newborn from a mother who is
HBsAg -positive, and horizontal transmission to the infant during the
first 5 years of life. Thus, it is critical that the infants born to
mothers who are HBsAg -positive are recognized and therapy initiated.
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Hep B Vaccine
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Maternal HBsAg Status
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HBIG
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First
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Second
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Third
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Positive
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Within 12 h of birth
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Within 12 h of birth
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1-2 months
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6 months
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Unknown
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Determine maternal HBsAg status: if positive, HBIG within
7 days. If negative, no HBIG
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Within 12 h of birth
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1-2 months
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6 months
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Negative
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No
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Birth to 2 months
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One month after first
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6 months after first
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Preterm Infants
For preterm infants born to HBsAg-positive mothers, both HBIG and
Hep B vaccines should be given within 12 h. For those born to
HBsAg-unknown mothers, the first vaccine should be given within 12 h
and if the maternal status cannot be determined within 12 h, HBIG
should be given.
Infants born to HBsAg-positive mothers should be serologically
tested for anti-HBs and HBsAg 1 to 3 months after completion of the
vaccination series; further vaccinations may be required.
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