Hepatitis B during Pregnancy

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KEY POINTS

• Hepatitis B is a serious viral infection of the liver. There are special concerns if you are pregnant and have hepatitis B or are at risk of getting hepatitis B.
• If you are pregnant and have hepatitis B, your baby will get 2 shots right after birth to help prevent your baby from becoming infected.
• Other treatment for you will depend on whether your hepatitis B infection is new or is ongoing (chronic).

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What is hepatitis B?

Hepatitis B is a serious viral infection of the liver, one of the largest organs. The liver helps your body digest and use food, helps clean your blood, and helps keep your body healthy. When you have hepatitis, the liver is irritated (inflamed). It may be swollen and tender, and areas of liver tissue may be destroyed. It can be life-threatening.

What is the cause?

Hepatitis B is very contagious. It is caused by the hepatitis B virus (HBV). You can get the virus from contact with the blood or other body fluids of someone who is infected with the virus. The disease can be spread by people who do not have any symptoms and may not know they carry the virus. Hepatitis B is not spread by hugging or kissing, sneezing, coughing, or casual contact. It is not usually spread through food, water, or breast milk.

You are at high risk for having hepatitis B if:

• You have had more than 1 sex partner in the last 6 months
• You have had unprotected sex with an infected person
• You use illegal injectable drugs and share needles, spoons, or other equipment
• You have been treated for HIV/AIDS or other sexually transmitted diseases
• You got a piercing or permanent tattoo with unclean equipment
• You have contact with the blood or open sores of an infected person
• You live or work in a prison, healthcare setting, nursing home, or rehabilitation center
• You have lived, traveled, or were born in an area with high rates of hepatitis B virus and have not been vaccinated against hepatitis
• Your mother had hepatitis B when she was pregnant with you

Talk to your healthcare provider if you have any of these risk factors or if you think you have been exposed to hepatitis B.

How does hepatitis B affect pregnancy?

If you have hepatitis B and are thinking about getting pregnant, talk with your healthcare provider. Some antiviral medicines used to treat hepatitis can cause serious harm or death to an unborn baby. The baby can be affected if the mother or the father is taking the medicine. You may need to use 2 types of birth control during and for several months after treatment.

When you are pregnant, hepatitis B will not hurt your baby during your pregnancy. But your baby can become infected at the time of birth. Your healthcare provider can prevent your baby from becoming infected at birth if you tell your provider that you have hepatitis B before delivery time.

Your healthcare provider will test you for hepatitis B at your first prenatal visit. If your test is positive, it means that either you are a hepatitis B virus carrier or that you have acute hepatitis B.

There are special concerns if you are pregnant and have hepatitis B or are at risk of getting hepatitis.

• If you do not have hepatitis B but you have a higher risk, your provider may advise that you get hepatitis B shots to prevent infection. It is best to get this vaccine before you are pregnant, but it can be given safely during pregnancy.
• If you are pregnant and have hepatitis B, your baby will get 2 shots right after birth to prevent your baby from becoming infected:
  • HBIG (hepatitis B immune globulin)
  • The first dose of the hepatitis vaccine within 12 hours after birth

How can I have a healthy pregnancy?

If you have hepatitis B, talk with your healthcare provider before you become pregnant. Knowing all of the possible risks can help you make good decisions about your medical care.

Until your hepatitis is under good control, use a reliable form of birth control. Talk to your healthcare provider about what form of birth control is safe for you.

While you are pregnant, you may need extra care such as:

• More frequent checks with your healthcare providers
• Blood tests to check your liver
• Changes in your medicine while you are trying to get pregnant and during pregnancy

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Keep all of your appointments with all your healthcare providers.
• Eat healthy meals that include whole grains, fresh fruits and vegetables, and calcium-rich foods, such as milk, cheese, and yogurt. Choose foods low in saturated fat. Ask your provider if there are foods you should not eat or if you should limit how much you eat.
• Drink plenty of water each day unless your healthcare provider has advised you to limit liquids.
• Take vitamins, other supplements, and medicines only as recommended by your healthcare provider. Talk to your provider before you take any medicine, including nonprescription and herbal medicines. Some medicines are not safe during pregnancy.
• Unless your healthcare provider tells you not to, try to be physically active for at least 30 minutes a day, most days of the week. You might find it easier to exercise 10 minutes at a time, 3 times a day. You may want to take a prenatal exercise class.
• Do not smoke, drink alcohol, or take illegal or recreational drugs.
• Other treatment for you will depend on whether your hepatitis B infection is new or is ongoing (chronic).
• In most cases, if the baby gets the recommended shots right after birth, breast-feeding should be safe.

How can I help prevent hepatitis B?

The hepatitis B shot is recommended if you have a higher risk for having hepatitis B or if you have diabetes, kidney failure, or long-term liver disease of any kind. All children should get a 3-shot series of hepatitis B shots in infancy.

If you have hepatitis B, to avoid spreading the disease to others:

• Don’t let others come into contact with your blood or other body fluids, including saliva.
• Clean any blood spills or stains with a mixture of 1 part household bleach to 9 parts water.
• Cover any cuts and sores. Change dressings often to keep them clean and dry.
• Don’t share anything that might have blood on it, such as needles, toothbrushes, or razors.
• Avoid sexual contact with others until your provider says it’s OK. Then use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex. Have just 1 sexual partner who is not having sex with anyone else.
• Don’t donate blood, body organs, other tissues, or sperm.
• Tell your all health care providers including your dentist that you have hepatitis B.
• Talk to your healthcare provider before getting pregnant.
• All people who live with you should get the hepatitis B vaccine to prevent infection with the hepatitis B virus.

You can get more information from:

• Centers for Disease Control and Prevention
  800-232-4636
  http://www.cdc.gov/hepatitis