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Hepatitis B and C during pregnancy

Hepatitis B (HBV) and C (HCV) infections are caused by viruses which are contracted by body fluid exposure e.g. blood and semen. Acute and chronic forms of Hepatitis B exist and testing is performed in early pregnancy to detect maternal hepatitis status.

Mother to baby transmission

Hepatitis B and C

Hepatitis B and C can be passed from a mother to her baby during birth. Having a caesarean birth does not prevent the virus from being transmitted from mother to baby; therefore, a vaginal birth is encouraged, if no other complications exist.

Acute hepatitis B

Acute infection with hepatitis B during pregnancy is uncommon and the risk of the unborn baby becoming infected, following an acute infection, is unusual.

Chronic hepatitis B

While transmission during pregnancy is rare, transmission at the time of birth is common and occurs as a result of exposure to maternal blood in the birth canal. There is no evidence that caesarean birth prevents transmission.

Without treatment, the overall risk of HBV transmission from the mother to infant is about 40 per cent, and up to 90 per cent if the mother has high levels of Hepatitis B virus in her blood stream.

Babies born to women with chronic hepatitis B should receive hepatitis B immunoglobulin (HBIG) and HBV vaccine at birth. HBIG provides immediate protection to the infant, but the effect only lasts a few months. The infant also receives the hepatitis B vaccine at birth, two and four months with one further does at either six or 12 months. Finishing all four doses is important for long-term protection. Immunisation at this time is more than 90 per cent effective at preventing transmission. In some cases, the mother is given a medication during pregnancy to reduce the amount of virus in her blood for several weeks before giving birth.

Hepatitis B vaccines are safe and highly effective in preventing hepatitis B infection and are now given routinely to newborns and children in Australia as part of the National Immunisation Program.

Chronic hepatitis C

Women with hepatitis C virus (HCV) usually have an uncomplicated pregnancy if no other complications are present.

Transmission of the virus from the mother to the infant appears to be much less efficient than for hepatitis B, occurring in about five to 10 per cent of infants born to hepatitis C RNA positive women. Prolonged rupture of membranes (less than six hours) may increase the risk of transmission; however, caesarean birth does not appear to reduce the risk.

Breastfeeding

In most circumstances breastfeeding is considered to be safe in women with Hepatitis B or C. For further information about breastfeeding with hepatitis B or C please refer to Mater's brochure: Breastfeeding—with infectious diseases.

Mater acknowledges consumer consultation in the development of this patient information.
Last modified 18/11/2015.
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