PT  - JOURNAL ARTICLE
AU  - N. B. Okun
AU  - R. P. Larke
AU  - J. R. Waters
AU  - M. R. Joffres
TI  - Success of a program of routine prenatal screening for hepatitis B surface antigen: the first 2 years
DP  - 1990 Dec 15
TA  - Canadian Medical Association Journal
PG  - 1317--1321
VI  - 143
IP  - 12
4099  - http://www.cmaj.ca/content/143/12/1317.short
4100  - http://www.cmaj.ca/content/143/12/1317.full
SO  - CMAJ1990 Dec 15; 143
AB  - Prenatal screening for hepatitis B surface antigen (HBsAg) restricted to women with defined risk factors for chronic hepatitis B virus (HBV) infection fails to identify many carriers. A centralized program of routine HBsAg screening for all pregnant women in Alberta was introduced in 1985. We collected and analysed data for the first 2 years of the program in Edmonton to determine the frequency of risk factors for HBsAg positivity, the proportion of multiparous HBsAg-positive women not identified in previous pregnancies, the efficiency and cost-effectiveness of providing immunoprophylaxis to infants at risk of HBV infection and the degree of success in inducing adequate protection. A total of 149 women (158 pregnancies) were found to be HBsAg positive. Risk factors were readily ascertainable for 85% of the women; the remaining 15% would not have been identified through risk-selective screening. The most common risk factors were Oriental ethnic origin, history of hepatitis, jaundice or multiple transfusions of blood or blood products, and occupational exposure to blood. Although 86% of the multiparous HBsAg-positive women had risk factors, only 7% had been identified in previous pregnancies. The Alberta program appears to be cost-effective. We conclude that only routine prenatal screening will identify all infants at risk of perinatal HBV infection and that a comprehensive public health program involving central laboratories, private physicians and public health staff can be highly effective and efficient in protecting infants against hepatitis B.