Maternal Factors Associated With Hepatitis B Transmission to Neonates; A Study Selected Antenatal Clinics in the Sekondi Takoradi Metropolis and Effia Kwesimintsim Municipality, 2019.

Abstract

Background: Neonatal Hepatitis B viral (HBV) infection is a public health concern worldwide. Prevalence of chronic HBV infection in Ghana is in excess of 8.0 %, and was 2.3 per 100,000 in Sekondi Takoradi in 2017. The purpose of the study was to determine maternal factors associated with transmission of Hepatitis B to newborn babies. Methods: A cross-sectional study involving pregnant women was carried out at antenatal units of selected hospitals in the Sekondi Takoradi Metropolis. Hepatitis B positive pregnant women of 34-37 weeks gestation were recruited into the study. Demographic information was collected from the mothers and a review of their antenatal record books performed to extract data on their medical and obstetric history. Maternal venous blood was collected and Hepatitis B viral load and e-antigen level assessed. Cord blood samples were collected and tested for Hepatitis B virus infection in the babies. Results: Eighty-nine Hepatitis B positive mothers had their babies screened for HBV. Prevalence of neonatal HBV was found to be 17.98% (16/89). Birthweight of infected babies was significantly higher than the uninfected babies (3.33kg vs. 3.12kg, p-value=0.043). Viral load (935.18 IU/mL) of mothers whose babies were not infected was lower compared to viral load (4178.63 IU/mL) of mothers of the infected babies (p-value <0.001). Prevalence of neonatal infection of hepatitis B e-Antigen positive mothers was higher (81.82% vs. 31.82%, p-value 0.007). There was no significant association between mode of delivery of the baby and its infection status. Conclusion: Mother-to-child transmission of (HBV) in this study occurred in babies with higher birthweight, and whose mothers had high Hepatitis B viral DNA and were HBV e Antigen positive. Hence, HBV DNA levels, HBV profile and use of antivirals, be incorporated into routine Antenatal services in Sekondi Takoradi.