Hepatitis may not always be a matter of concern for an unborn child. If the mother is aware of the status regarding her disease she may take precautionary measures to avoid the transmission from her body to the baby. The most important point to consider here is the knowledge about the disease rather than the disease itself. However on saying that one cannot rule out the fact that the child may contract it from the mother’s condition on varied circumstances. In this document, we are going to talk about the three major forms of hepatitis, i.e, Hepatitis A, B, and C, which may affect an unborn child.
Transmission Of Hepatitis From Mother To Child
This form of hepatitis can be a major concern for the mother and child. Several studies show that babies born to mothers suffering from hepatitis B surface antigen (HBsAg) and hepatitis B “e” antigen (HBeAg) have a 70% to 90% chance of contracting the infection. However, in case the mother is suffering from only HBsAg then the chance of babies getting infected goes down to 10%. Out of the infected babies, around 85% to 90% can become chronic carriers of HBV and out of them more than 25% may die due to factors such as primary hepatocellular carcinoma or cirrhosis of the liver.
Another major concern related to HBV is that it can get transmitted into the baby at any time during the birth cycle, that is when the baby is in the womb or during labor or delivery. Though there is no specific advice related to the delivery process, that is, Vaginal or C Section, HBV DNA testing is to be done during pregnancy to reduce the transmission risk. If the HBV DNA level is greater than 200,000 IU/ML then the mother is provided with antiviral therapy to reduce the prenatal HBV transmission. However, even if the mother is HBV negative, routine tests are performed during pregnancy to ascertain that such disease will not infect the baby. (Learn more from Debunking Myths about Hepatitis B)
Unlike HBV, Hepatitis C does not get transmitted into an unborn child before delivery. In other words, it is only during childbirth that this infection may be transmitted from mother to child. According to various sources the overall transmission risk for a positive HCV mother is approximately 4% to 8%. However, the transmission risk gets significantly higher in case the mother has a high HCV viral load or if the mother is co-infected with HIV. In such cases, the risk ranges from 8% to 15% per pregnancy. However, most babies infected with HCV have no symptoms and they are generally tested after 18 months from the delivery process. Similar to HBV, doctors also recommend HCV and HIV as routine examinations to pregnant women except in situations where HCV prevalence is less than 0.1% .
Though Hepatitis A infection is a major cause of acute viral hepatitis among adults however it is rarely reported during pregnancy. Overall HAV during pregnancy is not associated with any serious outcomes. However if a pregnant woman is HAV positive she may go into premature labor, especially if such infection occurs during the second or third trimester. HAV has also been reported to cause other problems such as premature uterine contractions, placental abruption, etc.
It must be noted that breastfeeding does not transmit any of the above categories of hepatitis. However, if there are any cracks on the nipple it can be a matter of concern and informed to the doctor immediately.
Prevention From Transmission
Among the three forms of hepatitis, HAV is generally short term and not chronic. However HBV and HCV can be acute, which is short term, or chronic, that is long term. Moreover, unlike Hepatitis A and B, Hepatitis C has no vaccines to prevent such disease.
If the mother is Hepatitis B positive, then the baby is vaccinated with the first dose within a few hours of his birth. The remaining two doses are given within 6 months from the birth date. However, if the mother is not Hepatitis B positive then the baby is vaccinated for the same before leaving the hospital or within 2 months from birth. Remaining doses, in this case, are given between 6 to 18 months of birth. Post the completion of vaccination the baby is tested for Hepatitis B.
Preterm babies born to HBV positive mothers with unknown HBsAg status receive immunoprophylaxis with hepatitis B vaccine along with hepatitis B immune globulin ( HBIG) within 12 hours of their birth.
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