It’s not surprising that many pregnant women are completely unaware they have been infected with a hepatitis virus. Usually this is because any symptoms of the illness may only be felt very vaguely, or there may be no symptoms at all. This is why good antenatal care and blood screening are really important during pregnancy, as early detection of potential problems enables better health outcomes. This knowledge allows you to make more healthful and healing choices in your day-to-day life, thereby improving and strengthening your liver and immune system during and after the pregnancy. Ongoing post-natal care is very important for both mother and baby as you will need to have your liver function checked regularly as well as tests checking viral blood levels.
Naturally, if you are pregnant and have a hepatitis virus, one of your greatest concerns will be for your unborn child. We hope this article will shed some light on several of the most common concerns:
- Can being pregnant affect the hepatitis?
- Can the hepatitis virus affect my baby either whilst I’m pregnant or after the baby is born?
It is a fact that regardless of which type of hepatitis infection you have, there is always a risk that you can pass it on to your baby. After all, viral hepatitis is contagious, albeit in varying degrees. In the majority of cases, however, pregnancy does not worsen hepatitis itself, except in certain circumstances involving viral hepatitis E.**
If you have had hepatitis for a long time, and your liver has been affected by cirrhosis, the extra demands placed on your liver that occurs during pregnancy may predispose you to some additional health issues, e.g. acute fatty liver. This condition can sometimes escalate during pregnancy and become severe, requiring early medical intervention such as a quick delivery etc. It would be advantageous to pay particular attention to your diet, and include foods that are liver friendly, and stay away from all alcohol.
A further complication from hepatitis involves a higher risk of gallstones (cholelithiasis). This occurs in approximately 6% of all pregnancies, partly due to changes in the bile salts which occurs during pregnancy. When you are pregnant, the gallbladder is slower at emptying, allowing these bile salts to sit around for longer periods of time. Sometimes this can cause jaundice during pregnancy, and removal of the gallbladder may become necessary.
Pregnancy and Hepatitis A: This virus is transmitted via an oral-fecal route, e.g. diapers or contaminated food or water. A blood test checks for IgM anti-HAV antibodies, which are detectable for months after the original infection has occurred. Usually a nutritious healthy diet and rest is required, and recovery should occur within a few months. When the newborn is exposed to the virus, the infection is usually only mild and the child will have a lifelong immunity to the disease. If you become exposed to hepatitis A whilst you are pregnant, an injection of immune gamma globulin (IG) is given to help protect you from getting the disease and is usually effective.
Pregnancy and Hepatitis B: Hepatitis B is spread via direct contact with body fluids such as blood, semen and vaginal fluids from someone who is already infected. It is the most frequently transmitted form of hepatitis from mother to baby world-wide, with the statistical risks being greater if you live in a developing country. Around 90% of pregnant women with acute hepatitis B infection will pass on the virus to their baby. Between 10 – 20% of women with chronic hepatitis B infection will also pass it on. Usually this disease is passed on from mother to baby during the delivery/birthing process, where baby is exposed to blood and bodily fluids. Hepatitis B is not spread by breast milk. The benefits of breast feeding outweigh any potential risk of infection, which is minimal.
If you have tested positive to hepatitis B during antenatal testing, you will be given an injection of hepatitis B immune globulin (HBIG). This vaccine contains antibodies against the virus and can give additional protection. Within the first 12 hours of baby being born, it should receive two injections. Firstly a dose of hepatitis B vaccine then a further dose of hepatitis B immune globulin (HBIG). Two further doses are given up to 6 months of age. Baby will need to be checked for the presence of the virus afterwards.
Pregnancy and Hepatitis C: Hepatitis C is spread via exposure to contaminated blood, e.g. blood transfusions, contaminated needles, injected drug use, even household items which come into contact with contaminated blood. Babies may be infected with the hepatitis C virus during birth if mom has the virus. The virus is not spread via breast milk.
Approximately 4% of women infected with the Hepatitis C virus pass it on to their baby. This risk is related to levels of quantitative hepatitis C RNA (the amount of virus) in the blood, as well as being positive to the HIV virus. Mothers without hepatitis C RNA in their blood do not transmit hepatitis C infection to their babies. Pregnant women will need to have liver function tests done on a regular basis.
** Hepatitis E is a rare and sporadic viral infection of the liver which occurs in industrialized countries such as the United States. Its risk of transmission is highest in regions of the world where there are low standards of sanitation. It is transmitted via the fecal-oral route through contaminated water. When this illness affects pregnant women, they may experience a more severe form of illness, which may possibly lead to acute liver failure, and a higher risk of fetal mortality.
The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.
The American College of Obstetricians and Gynecologists – FAQ Frequently Asked Questions FAQ 093 Pregnancy; “Hepatitis B and Hepatitis C in Pregnancy”.
M.D. Hunt, Christine, “Liver Disease in Pregnancy”, American Family Physician, Feb 15, 1999.