Vertical transmission of hepatitis B
infection can be prevented with appropriate antenatal serologic screening of
pregnant women. For infants born to HBsAg seropositive mothers, appropriate
immunoprophylaxis includes administration of hepatitis B vaccine and hepatitis
B immune globulin.
For a variety of reasons, including inability
to access maternal records, maternal hepatitis B serostatus may be unknown at
the time of delivery. In these cases, HBsAg serology on the mother should be drawn
immediately onadmission for delivery, and the hepatitis B vaccine should be administered
to the neonate within 12 hours of age. Guidelines for administration of
hepatitis B immune globulin are based on infant weight (using a weight cutoff
of 2000 g) as well as the timing of determination of maternal serology status.
Because of the variable immune response to
the hepatitis B vaccine in neonates born under 2000 g, hepatitis B immune globulin
should be given to these infants if maternal serology status cannot be
determined within 12 hours. For infants with a birth weight over 2000 g, immune
globulin administration may be delayed if the maternal serology status can be determined
within 7 days. Infants born to mothers who are HBsAg negative should only
receive the hepatitis B vaccine.
Maternal chorioamnionitis and hepatitis C
seropositive status are not indications for administration of hepatitis B
immune globulin.
CORRECT OPTION IS 'E'
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