Pregnancy and Hepatitis Virus: How to Minimize the Risk to the Baby

Hepatitis B and hepatitis C can both cause short and long-term health issues. When a mom with hepatitis becomes pregnant, she can work with her healthcare provider to minimize the risk to her baby. Screening expectant mothers is the first step, as many don’t realize they are carriers of the hepatitis virus. This article will explore the ways in which the baby can be affected by hepatitis.

Key takeaways:
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    Hepatitis viruses are very contagious, and many people are unaware they are carriers.
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    Hepatitis B and Hepatitis C can be mild or asymptomatic but sometimes become chronic hepatitis, and cause life-long liver problems.
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    Screening pregnant mothers for hepatitis B and hepatitis C can help guide care for the mother and her newborn.
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    Hepatitis B immune globulin and vaccination given in the first hours of life can be very effective at preventing transmission of Hepatitis B from mother to infant.

What is hepatitis?

The term hepatitis means inflammation of the liver. Alcohol use, toxins, some medications, and medical conditions can cause hepatitis. Viruses can also cause hepatitis, sometimes leading to long-term liver problems.

Hepatitis A, hepatitis B, and hepatitis C are the most common viruses causing hepatitis. Symptoms of viral hepatitis may take weeks, months, or even years to develop. Hepatitis can cause a decreased appetite, stomach upset, fatigue, pale stools, joint aches, and jaundice. Some people may become carriers of the hepatitis virus without showing symptoms.

Types of viral hepatitis

Several viruses can cause hepatitis. Although they all can cause similar symptoms, there are some notable differences between the types of hepatitis.

Hepatitis AHepatitis A is transmitted through feces. Ingesting even the tiniest bit of fecal matter from an infected person can transmit hepatitis A. The good news is that, unlike other hepatitis viruses, hepatitis A usually goes away after several weeks or months and typically does not cause long-term liver problems.
Hepatitis BInfected body fluids such as blood, semen, or vaginal fluids are responsible for transmitting hepatitis B. Most children and adults exposed to hepatitis B will develop an acute infection but then develop life-long immunity to the virus. However, others will develop chronic hepatitis B and become life-long carriers.
Hepatitis C
Hepatitis C is spread through blood. Even tiny, microscopic amounts of blood are enough to spread the virus. Symptoms from hepatitis C can be mild to severe, lasting weeks to years. Most people infected with hepatitis C will become chronic carriers if not treated. There are effective medications to treat hepatitis C. However, sometimes hepatitis C can cause serious liver problems such as cirrhosis or cancer.

How common is hepatitis?

According to the CDC, hepatitis is common — with millions of people in the United States living with chronic viral hepatitis. Maybe more concerning is that an estimated 50% of those with hepatitis B or hepatitis C do not know they are infected. The highly contagious nature of these viruses explains why there are nearly 100,000 new cases each year.

Hepatitis in pregnancy

Hepatitis A is generally not a concern during pregnancy. However, if a mom has hepatitis B or hepatitis C, this can affect the baby.

Because hepatitis can infect so many people without them knowing, pregnant women should be tested for hepatitis B and C during pregnancy as part of routine screening. Although pregnancy complications related to hepatitis are rare, screening for infection in the mom is vital to ensure both mom and baby have a proper follow-up.

How to avoid transmitting hepatitis to your baby

Because hepatitis B and C are transmitted through body fluids, the baby is at risk of exposure during birth. The good news is that there are things that can lower a baby’s risk.

If a mother has hepatitis B, the baby should receive hepatitis B immune globulin (HBIG) and hepatitis B vaccination within 12 hours of birth. The HBIG provides temporary protection from hepatitis B. Meanwhile, the vaccination will prompt the baby’s immune system to make antibodies against the virus, providing life-long immunity. If given together within 12 hours of birth, these two injections are 94% effective at preventing the newborn from becoming infected with hepatitis B.

Anti-viral medications can be very effective at suppressing or curing hepatitis C. If a mother is known to carry hepatitis C before pregnancy, treatment can be very effective at lowering or eliminating the virus in the body. Treatment reduces the risk of transmitting it to the baby during pregnancy. About 4% of babies born to mothers with hepatitis C will become infected.

Long-term follow-up for babies born to mothers with hepatitis

Babies who received hepatitis B vaccination after birth will require at least two more doses to remain protected. Once they have finished their vaccination series, they should be tested for hepatitis B and referred to a specialist in the rare event that they are positive.

No vaccination is available to prevent hepatitis C. Although transmission from mother to baby is not common, especially if the mother was treated before pregnancy, babies born to mothers with hepatitis C should be tested for the virus by about 18 months. If positive, a specialist should monitor the baby and consider possible treatment.

Viral hepatitis can vary from person to person, but can sometimes cause long-term problems. Screening for hepatitis B and C during pregnancy can help ensure that a hepatitis infection does not go unnoticed. Mothers and their healthcare providers can reduce the risk to babies by following available screening, treatment, and vaccination guidelines.

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