After Implementation of a Universal Neonatal and Childhood Hepatitis B Vaccination Program: Is Universal Prenatal Hepatitis B Screening Still Necessary?

Objectives: To study the seroprevalenc of hepatitis surface antigen (HbsAg) among pregnant women attending their first prenatal examination and the value of the current policy of universal screening of pregnant women for hepatitis virus infection (HBV) among our local population. Setting: King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia. Methods: A retrospective analysis of routine prenatal hepatitis B screening test results of women attending their first prenatal visit over a period of 4 years (between 1 January 2004 and 31 December 2007). Hepatitis B surface antigen (HBsAg) screening tests results were reviewed and analyzed with respect to age, nationality, gravidity, parity, and the number of abortions. Results: The sample study comprised of 8989 pregnant women attending for their first prenatal visit. Only 18 out of 8989 screened women (0.2%, 95% CI: 0.1-0.3%) were seropositive for HBsAg and one (0.01% of the entire cohort), was hepatitis B e antigen (HBeAg)-positive. Conclusion: The very low prevalence (0.2%) of seropositive cases does not justify the continuation of universal screening program for pregnant women, at least among women in Jeddah area. There is also evidence that the national vaccination program against HBV mounted by the Ministry of Health in Saudi Arabia has positive impact on HBV infection among women generation who are now in their reproductive age. A national policy for optimum screening of pregnant women requires national study to evaluate the prevalence of HBV in different areas of the country, and the impact of the national vaccination program.