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. 1995 Nov 4;311(7014):1200–1202. doi: 10.1136/bmj.311.7014.1200

Programme for preventing perinatal hepatitis B infection through screening of pregnant women and immunisation of infants of infected mothers in The Netherlands, 1989-92. National Hepatitis B Steering Committee.

P M Grosheide 1, J M Klokman-Houweling 1, M A Conyn-van Spaendonck 1
PMCID: PMC2551117  PMID: 7488896

Abstract

OBJECTIVES--To launch a programme for the prevention of perinatal infection with hepatitis B in the Netherlands. DESIGN--Routine antenatal screening and intervention programme. SETTING--Community antenatal programme, the Netherlands. SUBJECTS--Infants of mothers who were carriers of hepatitis B detected by routine screening. INTERVENTIONS--Infants of infected mothers received hepatitis B immunoglobulin at birth and four doses of hepatitis B vaccine in conjunction with routine immunisation at 3, 4, 5, and 11 months of age. MAIN OUTCOME MEASURES--Results of screening and immunisation from 1989-92. RESULTS--The coverage of screening increased from 46% in 1989 to 84% in 1992. Hepatitis B surface antigen was detected in 2145 women (0.44%). The coverage of postnatal immunoprophylaxis in 1645 neonates born to mothers who were carriers of hepatitis B was 85% (1391); in 3% (42) there was a delay in administration of immunoglobulin of over 24 hours. In 1991, 96% (537), 95% (532), 94% (525), and 87% (489) of the infants received the first, second, third, and fourth dose of vaccine, respectively. There was considerable variation in the timing of vaccination; 17% (258) of the infants received their first dose more than two weeks late. Of the 59% (583) of infants who received the fourth dose more than two weeks beyond target age, 14% (141) also received their first dose too late. CONCLUSIONS--A prevention programme for perinatal hepatitis B in an area of low prevalence, when incorporated into existing health care, is feasible and achieves satisfactory coverage rates. Intensive follow up is needed to improve adherence to the immunisation schedule.

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Selected References

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  1. Beasley R. P., Hwang L. Y., Lee G. C., Lan C. C., Roan C. H., Huang F. Y., Chen C. L. Prevention of perinatally transmitted hepatitis B virus infections with hepatitis B immune globulin and hepatitis B vaccine. Lancet. 1983 Nov 12;2(8359):1099–1102. doi: 10.1016/s0140-6736(83)90624-4. [DOI] [PubMed] [Google Scholar]
  2. Beasley R. P., Hwang L. Y., Stevens C. E., Lin C. C., Hsieh F. J., Wang K. Y., Sun T. S., Szmuness W. Efficacy of hepatitis B immune globulin for prevention of perinatal transmission of the hepatitis B virus carrier state: final report of a randomized double-blind, placebo-controlled trial. Hepatology. 1983 Mar-Apr;3(2):135–141. doi: 10.1002/hep.1840030201. [DOI] [PubMed] [Google Scholar]
  3. Chen D. S., Hsu N. H., Sung J. L., Hsu T. C., Hsu S. T., Kuo Y. T., Lo K. J., Shih Y. T. A mass vaccination program in Taiwan against hepatitis B virus infection in infants of hepatitis B surface antigen-carrier mothers. JAMA. 1987 May 15;257(19):2597–2603. [PubMed] [Google Scholar]
  4. Grosheide P. M., del Canho R., Heijtink R. A., Nuijten A. S., Zwijnenberg J., Bänffer J. R., Wladimiroff Y. W., Botman M. J., Mazel J. A., de Gast G. C. Passive-active immunization in infants of hepatitis Be antigen-positive mothers. Comparison of the efficacy of early and delayed active immunization. Am J Dis Child. 1993 Dec;147(12):1316–1320. doi: 10.1001/archpedi.1993.02160360058019. [DOI] [PubMed] [Google Scholar]
  5. Henning K. J., Pollack D. M., Friedman S. M. A neonatal hepatitis B surveillance and vaccination program: New York City, 1987 to 1988. Am J Public Health. 1992 Jun;82(6):885–888. doi: 10.2105/ajph.82.6.885. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Inskip H. M., Hall A. J., Chotard J., Loik F., Whittle H. Hepatitis B vaccine in the Gambian Expanded Programme on Immunization: factors influencing antibody response. Int J Epidemiol. 1991 Sep;20(3):764–769. doi: 10.1093/ije/20.3.764. [DOI] [PubMed] [Google Scholar]
  7. Jonas M. M., Reddy R. K., DeMedina M., Schiff E. R. Hepatitis B infection in a large municipal obstetrical population: characterization and prevention of perinatal transmission. Am J Gastroenterol. 1990 Mar;85(3):277–280. [PubMed] [Google Scholar]
  8. Mazel J. A., Schalm S. W., de Gast B. C., Nuijten A. S., Heijtink R. A., Botman M. J., Bänffer J. R., Gerards L. J., Zwijnenberg J., Mettau J. Passive-active immunisation of neonates of HBsAg positive carrier mothers: preliminary observations. Br Med J (Clin Res Ed) 1984 Feb 18;288(6416):513–515. doi: 10.1136/bmj.288.6416.513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Niu M. T., Targonski P. V., Stoll B. J., Albert G. P., Margolis H. S. Prevention of perinatal transmission of the hepatitis B virus. Outcome of infants in a community prevention program. Am J Dis Child. 1992 Jul;146(7):793–796. doi: 10.1001/archpedi.1992.02160190025012. [DOI] [PubMed] [Google Scholar]
  10. Schalm S. W., Mazel J. A., de Gast G. C., Heijtink R. A., Botman M. J., Bänffer J. R., Cerards L. J., Zwijnenberg J., Fetter W. P., Nuijten S. M. Prevention of hepatitis B infection in newborns through mass screening and delayed vaccination of all infants of mothers with hepatitis B surface antigen. Pediatrics. 1989 Jun;83(6):1041–1048. [PubMed] [Google Scholar]
  11. Stevens C. E., Toy P. T., Tong M. J., Taylor P. E., Vyas G. N., Nair P. V., Gudavalli M., Krugman S. Perinatal hepatitis B virus transmission in the United States. Prevention by passive-active immunization. JAMA. 1985 Mar 22;253(12):1740–1745. [PubMed] [Google Scholar]
  12. Stroffolini T., Pasquini P., Mele A. A nationwide vaccination programme in Italy against hepatitis B virus infection in infants of hepatitis B surface antigen-carrier mothers. Vaccine. 1989 Apr;7(2):152–154. doi: 10.1016/0264-410x(89)90056-x. [DOI] [PubMed] [Google Scholar]
  13. Verbrugge H. P. The national immunization program of The Netherlands. Pediatrics. 1990 Dec;86(6 Pt 2):1060–1063. [PubMed] [Google Scholar]
  14. West D. J., Calandra G. B., Hesley T. M., Ioli V., Miller W. J. Control of hepatitis B through routine immunization of infants: the need for flexible schedules and new combination vaccine formulations. Vaccine. 1993;11 (Suppl 1):S21–S27. doi: 10.1016/0264-410x(93)90154-p. [DOI] [PubMed] [Google Scholar]

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