Understanding Hepatitis B and C in Pregnancy

Reviewed by James Brann, MD
Both hepatitis B and hepatitis C affect the liver, and are serious infections. Viruses cause both, and both are contagious. As well, they can lead to long-term problems.
With hepatitis B and hepatitis C during pregnancy, a woman may pass these viruses on to her unborn child. Sometimes, a woman may not even know she has an infection because she doesn’t have any symptoms.

How is hepatitis B spread?

Hepatitis B is spread when you come in direct contact with an infected person’s bodily fluids. This includes vaginal fluids, semen or blood. This could happen by sharing drug needles or during unprotected sex.

If a pregnant woman has hepatitis B, she may infect her child during delivery. You can also spread hepatitis B by living with an infected person and sharing things like razors or a toothbrush. Hepatitis B can’t be spread by simple casual contact, and it’s not spread by breastfeeding.

Acute hepatitis B

With hepatitis B, it can be either chronic or acute. With acute infection, the illness is short-term and occurs during the first six months after infection. Symptoms may include:
  • A loss of appetite
  • Being tired
  • Jaundice (yellowish eyes and skin)
  • Vomiting and nausea
  • Joint and muscle pain
  • Stomach pain

An infection like this may clear up without treatment in just a few weeks. If you don’t get rid of the virus, you become immune to it, and you can’t get it again.

Chronic hepatitis B

A small percentage of adults and kids under five who are infected will never get rid of the hepatitis B virus. In this case, it’s referred to as chronic infection. These people become carriers, and the virus stays with them forever. In most carriers, there are no symptoms. However, for a small group of carriers, chronic infection can lead to some serious problems like liver cancer, early death and cirrhosis of the liver.

Curing hepatitis B

Unfortunately, there is no cure for hepatitis B, but you can help manage the symptoms. There’s also a vaccine on the market, which can help prevent hepatitis B. If you’ve been in contact with the virus and haven’t been vaccinated, you can get a shot. It’s called hepatitis B immune globulin, or HBIG, as well as getting the vaccine. HBIG will contain antibodies against the virus. In some situations, it gives a person extra protection against infections.

Hepatitis B and your baby

In about 90% of cases, women who have acute hepatitis B pass it along to their children. The number drops to between 10-20% of women who have chronic infections.
For babies, hepatitis B can be severe. It could also be life threatening. An infected newborn has up to a 90% chance of becoming a carrier. They’ll also then be able to pass the virus along to other people. After they become an adult, they’ll have about a 25% chance of dying from liver cancer or cirrhosis of the liver.

Testing for hepatitis B

Every pregnant woman will be tested for hepatitis B. There are different blood tests out there, though, for the hepatitis B infection. These types of tests can tell whether a person was recently infected, or if they’re a carrier. They’ll also let you know if you’ve ever had the hepatitis B virus before and if you’re immune, or even if you had the vaccine.

If the tests come back positive for infection, you’ll want more tests to check on your general health and your liver. This also means any other children you have, your sexual partners and anyone living in your home is at risk of becoming infected.

Hepatitis B and delivery

Being infected with hepatitis B won’t affect your delivery. It doesn’t mean you won’t be able to have a vaginal delivery, either.

It also doesn’t mean you can’t breastfeed your child.

Preventing infection

Sometime within the first few hours of delivery, your child will get their first dose of the hepatitis B vaccine. They’ll also get an HBIG shot. Your child gets two additional vaccine doses within the next six months. After all the vaccines, doctors will test your baby for the infection.

If your baby does test positive for the hepatitis B virus, they’ll need frequent medical care. Doctor visits will help check on your baby’s health and make sure their liver is working normally.

Every baby is vaccinated against the hepatitis B virus. If you’re not infected, your baby gets dose one of the vaccine before leaving the hospital. If not, your baby gets it sometime within the first two months. The other doses are given between months 6-18.

Vaccinating against hepatitis C infection

There’s no vaccine for hepatitis C. The only way you can prevent infection is by avoiding certain types of behavior. Hepatitis C is most prevalent in people born between the years of 1945-1965. Everyone in this age group needs to be tested.

How is hepatitis C spread?

Direct contact with infected blood is what causes the spread of hepatitis C. This could happen by sharing needles, or even sharing normal household items that come in contact with blood. If a mother is infected, she may infect her baby during delivery. Hepatitis C is also spread during unprotected sex, but it’s not as common. You can’t spread it through casual contact or breastfeeding.

Symptoms of hepatitis C

Hepatitis C is similar to hepatitis B when it comes to the symptoms. In other cases, there are no symptoms, though. About 75-85% of adults who are infected with the hepatitis C virus will become carriers. Most of them end up with long-term liver disease. A small amount of carriers develops life-threatening liver problems and cirrhosis of the liver.

Passing hepatitis C to your baby

Around four percent of women infected with hepatitis C pass it along to their babies. The level of risk is determined by how much virus the woman has, and whether she has HIV.

If you’re infected with the virus, doctors will want to test your baby at around 18 months or older. You can still breastfeed, even if you have the virus.

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