Viral Hepatitis and Pregnancy

Overview Pregnancy is generally considered to be an immunosuppressed state; however, the impact of pregnancy on mothers with viral hepatitis (Table 1) and the impact of viral hepatitis on fetuses/infants (Table 2) are not the same for all types of hepatitis. Pregnant women with acute hepatitis due to hepatitis E virus (HEV) or herpes simplex virus (HSV) have an increased risk of acute liver failure compared to persons who are not pregnant. Flares of chronic hepatitis B may occur during pregnancy and in the postpartum period, but hepatic decompensation is rare. The risk of vertical transmission of hepatitis viruses is higher in pregnant women with acute versus chronic infection. In general, the risk is not increased with amniocentesis, fetal monitoring, or vaginal birth, and cesarean should not be recommended to prevent transmission of hepatitis viruses. Breastfeeding is safe for women with chronic hepatitis B virus (HBV) or chronic hepatitis C virus (HCV) infections—unless they have cracked nipples. Hepatitis A and B vaccines are safe to be administered during pregnancy.