Charles Grose, MD
Peer Review Status: Internally Peer Reviewed

Mothers are routinely tested for the Hepatitis B surface antigen (HBsAg) status during their pregnancy. There is a risk of both vertical perinatal transmission to the newborn from a mother who is HBsAg -positive, and horizontal transmission to the infant during the first 5 years of life. Thus, it is critical that the infants born to mothers who are HBsAg -positive are recognized and therapy initiated.

Hepatitis B Surface Antigen Status table
Maternal HBsAg Status HBIG Hep B Vaccine
First
Hep B Vaccine
Second
Hep B Vaccine
Third
Positive Within 12 h of birth Within 12 h of birth 1-2 months 6 months
Unknown Determine maternal HBsAg status: if positive, HBIG within 7 days. If negative, no HBIG Within 12 h of birth 1-2 months 6 months
Negative No Birth to 2 months One month after first 6 months after first

Preterm Infants

For preterm infants born to HBsAg-positive mothers, both HBIG and Hep B vaccines should be given within 12 h. For those born to HBsAg-unknown mothers, the first vaccine should be given within 12 h and if the maternal status cannot be determined within 12 h, HBIG should be given.

Infants born to HBsAg-positive mothers should be serologically tested for anti-HBs and HBsAg 1 to 3 months after completion of the vaccination series; further vaccinations may be required.