Liver Disease

USPSTF: Screen for HBV in Pregnant Women

The US Preventive Services Task Force (USPSTF) has reaffirmed its recommendation to screen all pregnant women for hepatitis B virus (HBV) at their first prenatal visit.

“Screening for HBV infection during pregnancy identifies women whose infants are at risk of perinatal transmission,” the Task Force wrote.

“Data from a nationally representative sample showed a prevalence of maternal HBV infection of 85.8 cases per 100 000 deliveries from 1998 to 2011 (0.09% of live-born singleton deliveries in the United States). Although there are guidelines for universal infant HBV vaccination, rates of maternal HBV infection have increased annually by 5.5% since 1998.”

The aim of this update was to reaffirm the effectiveness and potential harms of screening and of case management to prevent perinatal transmission.

“Using a reaffirmation process, the USPSTF concludes with high certainty that the net benefit of screening for HBV infection in pregnant women is substantial,” the Task Force wrote.

Ultimately, the Task Force found:

  • Adequate evidence supporting the use of serologic testing for HBV in pregnant women;
  • Convincing evidence supporting universal prenatal screening reduces perinatal transmission of HBV;
  • Adequate evidence supporting vaccination of all infants against HBV infection reduces the risk for acquisition of HBV infection; and
  • Adequate evidence supporting the administration of postexposure prophylaxis with hepatitis B immune globulin at birth to infants whose mothers have HBV reduces the risk for acquisition of HBV infection.

“The USPSTF found limited evidence on the harms of screening for HBV infection in pregnant women but bounded the potential harms of screening as no greater than small based on the high accuracy of screening and the low likelihood of harms from preventive interventions,” the Task Force wrote.

—Amanda Balbi



Owens DK, Davidson KW, Krist AH, et al; US Preventive Task Force. Screening for hepatitis B virus infection in pregnant women: US Preventive Services Task Force reaffirmation recommendation statement. JAMA. 2019;322(4):349-354. doi:10.1001/jama.2019.9365.