During pregnancy, viral hepatitis can be caused by various viruses that infect the liver. It’s important to be aware of this and understand the different ways these infections can happen. Some viruses spread through contact with infected faeces, while others are passed from mother to baby, through blood, or even through sexual contact. Therefore, it’s crucial to ask about travel, eating habits, drug use, and sexual activity to determine the risk.
Although routine screening is recommended for hepatitis B and C, most other cases are identified when a pregnant person shows signs like tiredness, tummy discomfort, yellowing of the skin or eyes, or abnormal liver test results.
Testing can help confirm the diagnosis, and sometimes additional tests are needed for hepatitis B and C. For those at risk, vaccines are recommended to prevent hepatitis A and B. If there’s a risk of hepatitis A, a single immunoglobulin dose can be used, and vaccination can be an option if immunoglobulin isn’t available.
Pregnant individuals with active hepatitis B and a high viral load during the last trimester may receive antiviral therapy to prevent transmission to their baby. After birth, babies exposed to hepatitis B should get immunoglobulin and a vaccine.
Hepatitis C is becoming more common in women of childbearing age. Research is ongoing on how to manage this during pregnancy. Currently, a caesarean section is not recommended solely to reduce the risk of transmission.
Breastfeeding is okay for women with hepatitis A, B, and C. There’s also ongoing research into new ways to prevent and treat hepatitis B and C, and it’s important that these studies include pregnant and breastfeeding women.
Dionne-Odom J, Cozzi GD, Franco RA, Njei B, Tita ATN. Treatment and prevention of viral hepatitis in pregnancy. Am J Obstet Gynecol. 2022 Mar;226(3):335-346. doi: 10.1016/j.ajog.2021.09.002. Epub 2021 Sep 10. PMID: 34516961; PMCID: PMC8907340.
