Hepatitis B prevalence in an unregistered prenatal population. Implications for neonatal therapy.

Abstract

To evaluate the risk and associated cofactors for hepatitis B infection in inner-city pregnant women not registered for prenatal care. Fifteen-month survey of 208 patients not registered for prenatal care, compared with 1555 women registered for prenatal care during the same period. An urban university hospital prenatal clinic and labor unit. Unregistered patients had a significantly higher rate of hepatitis B surface antigen positivity than patients who had registered with the clinic (6.7% vs 0.8%; P less than .0001). Unregistered patients with positive results of urine drug screening (46%) had a relative risk for seropositivity of 29.2%, compared with registered patients who did not have histories of illicit drug use (95% confidence interval, 25.9% to 32.4%), while registered patients with past histories of drug use had a relative risk of 6.7%, compared with the reference group that did not have histories of drug use (95% confidence interval, 1.8% to 24.0%). Among inner-city pregnant women not registered for prenatal care, a positive result of urine drug screening is a rapidly available marker for increased risk of hepatitis B surface antigen positivity. Infants born to unregistered women with positive results of urine drug screening before maternal hepatitis B surface antigen results are available may warrant empiric initiation of hepatitis B virus-specific prophylaxis.