ACOG Endorses New Guidance and Algorithm for Prenatal HBsAg Tests: The Importance of Screening Pregnant Women for Hepatitis B Infection

In an important step to help prevent perinatal hepatitis B infection and chronic hepatitis in infancy, ACOG worked with the Centers for Disease Control and Prevention (CDC) and partners from health departments, commercial laboratories, and other professional organizations to include pregnancy status in laboratory test reports sent to health departments. This is critical to identify HBsAg-positive (hepatitis B infected) pregnant women and administer timely post-exposure prophylaxis in infancy. Chronic hepatitis B infection is a serious, vaccine-preventable illness that is a major cause of liver failure, liver cancer, and premature death in the United States.

HBsAg-positive tests are reportable to public health in all states, but pregnancy status is rarely reported. These efforts were guided by recommendations of the Council of State and Territorial Epidemiologists (CSTE) to improve identification of HBsAg-positive pregnant women.  

When ordering an HBsAg screening test for a pregnant or postpartum patient, ACOG recommends that you use a test designated as “Prenatal”. The success of timely identification and confirmatory testing for HBsAg-positive pregnant women is dependent on physician and hospital uptake of the designated prenatal HBsAg tests ordered from these laboratories.

Four major commercial laboratories now offer designated HBsAg tests for pregnant women as a standalone assay and/or as part of a prenatal/obstetric panel to facilitate reporting HBsAg-positive women to health departments. A summary of the available prenatal HBsAg tests and the ACOG/CDC Screening and Referral Algorithm for Hepatitis B Virus (HBV) Infection among Pregnant Women can be found on ACOG’s Immunization for Women website at:  

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998