Perinatal Infection Prevention Program
The Perinatal Infection Prevention Program’s goal is to prevent mother to child transmission of hepatitis B / hepatitis C / HIV and congenital syphilis infections through surveillance, case management, education, prenatal testing and policy recommendations. Some infections before and during pregnancy can be transmitted to the newborn during the birthing process.
Prevent Infections for Mom and Baby’s Protection:
TARGETED INFECTIONS AND INFORMATION ABOUT THE VIRUS
Hepatitis B Virus (HBV)
- Hepatitis B virus (HBV) infection in a pregnant woman poses a serious risk to her infant at birth. HBV can be transmitted from an infected mother to her child during the birthing process.
- All pregnant women should be tested for hepatitis B surface antigen (HBsAg) at an early prenatal visit during each pregnancy. Women who were not screened during pregnancy, who are at high risk (having more than one sex partner during the previous 6 months, an HBsAg-positive sex partner, evaluation or treatment for a sexually transmitted disease, or recent or current injection drug use) or with signs or symptoms of hepatitis should have blood drawn and tested/retested as soon as possible after admission to the labor and delivery unit.
- Perinatal HBV transmission can be prevented by identifying HBsAg-positive pregnant women and providing hepatitis B immune globulin (HBIG) and hepatitis B vaccine to their infants within 12 hours of birth, followed by the completion of the accelerated hepatitis B vaccine series at (0, 1 and 6 months for single-antigen) or (0, 2, 4, 6 months for combination vaccines). The post vaccination serologic testing (PVST) for HBsAg and anti-HBs should be completed at 9 to 12 months of age.
Hepatitis C Virus (HCV)
- HCV can be transmitted from an infected mother to her child during the birthing process. Pregnant women who are at increased risk (past or current injection-drug use, with HIV infection, having had a blood transfusion before July 1992, receipt of unregulated tattoo, having been on long-term hemodialysis, intranasal drug use, and other percutaneous exposures) should be tested for HCV at the first prenatal visit. HCV-infected pregnant women should be linked to care so that antiviral treatment can be initiated at the appropriate time (not during pregnancy).
- Infants born to HCV-infected mothers should be tested for anti-HCV no sooner than 18 months of age or HCV RNA can be performed at or after the infant’s first well-child visit at age 1-2 months. HCV RNA should then be repeated at a subsequent visit, independent of the initial HCV RNA test result.
Human Immunodeficiency Virus (HIV)
- Perinatal HIV transmission can happen at any time during pregnancy, labor, delivery, and breastfeeding. All pregnant women should be tested for HIV at an early prenatal visit during each pregnancy. Women who are at high risk for HIV (injection drug users and their sex partners, exchange sex for money or drugs, sex partners of HIV infected persons, who have had a new or more than one sex partner during the pregnancy, or have symptoms consistent with acute HIV infection) should be retested during the third trimester. Women who are not screened during pregnancy should have blood drawn and tested as soon as possible after admission to the labor and delivery unit.
- The earlier HIV is diagnosed and treated, the more effective HIV medicine, called antiretroviral treatment (ART), will be at preventing transmission and improving the health outcomes of both mother and child.
Congenital Syphilis (CS)
- Congenital syphilis is a disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy. CS can cause miscarriage, stillbirth, prematurity, low birth weight, or death shortly after birth.
- All pregnant women should be tested for syphilis during the first trimester and again during the third trimester for women who are at high risk or live in areas of high syphilis morbidity. At delivery, women who do not have test results should be tested/retested. Women testing positive should be treated and informed of the importance of being tested for other STI’s and HIV infection. Their partners should also be treated and plans should be made to treat their infants at birth. Penicillin is effective for preventing maternal transmission to the fetus, as well as treating fetal and maternal infection.
NVHR Releases Two New Fact Sheets Calling Attention to the Latest Issues in HCV Care
CDC Recommendations for HIV Among Pregnant Women, Infants and Children
Vaccines Routinely Recommended for Pregnant Women
- Is recommended for pregnant women and safe to administer during any trimester
- Is the best way to protect pregnant women and their babies from the flu, and prevent possible flu-associated pregnancy complications
- Is safe and can help protect the baby from flu for up to 6 months after birth, which is important because babies younger than 6 months of age are too young to get a flu vaccine
- Is recommended during every pregnancy, ideally during the third trimester
- When given during pregnancy, boosts antibodies in the mother, which are transplacentally transferred to her developing baby. Third trimester administration optimizes neonatal antibody levels
- Helps protect infants, who are at greatest risk for developing pertussis and its life threatening complications, until they are old enough to start the childhood pertussis vaccine series
Perinatal HIV Screening Benefits for Mom and Baby
Your Guide to Breastfeeding
The U.S. Department of Health and Human Services, Office on Women’s Health (OWH) is raising awareness of the importance of breastfeeding to help mothers give their babies the best start possible in life. Click here to view the Guide
Indiana Birthing Hospitals
Map with a list of Indiana Birthing Hospitals
Awards to Indiana hospitals in recognition of best practices in the prevention of perinatal hepatitis B infection from 2008-2017.