Published online May 2, 2005
PEDIATRICS Vol. 115 No. 5 May 2005, pp. e594-e599 (doi:10.1542/peds.2004-2057)
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Hepatitis B
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ELECTRONIC ARTICLE

Assessment of Perinatal Hepatitis B and Rubella Prevention in New Hampshire Delivery Hospitals

Susan Bascom, BSN, Stephanie Miller, MPH and Jesse Greenblatt, MD, MPH

From the New Hampshire Department of Health and Human Services, Division of Public Health Services, Concord, New Hampshire

Objective. To evaluate current performance on recommended perinatal hepatitis B and rubella prevention practices in New Hampshire.

Methods. Data were extracted from 2021 paired mother-infant records for the year 2000 birth cohort in New Hampshire's 25 delivery hospitals. Assessment was done on the following: prenatal screening for hepatitis B and rubella, administration of the hepatitis B vaccine birth dose to all infants, administration of hepatitis B immune globulin to infants who were born to hepatitis B surface antigen-positive mothers, rubella immunity, and administration of in-hospital postpartum rubella vaccine to rubella nonimmune women.

Results. Prenatal screening rates for hepatitis B (98.8%) and rubella (99.4%) were high. Hepatitis B vaccine birth dose was administered to 76.2% of all infants. All infants who were born to hepatitis B surface antigen-positive mothers also received hepatitis B immune globulin. Multivariate logistic regression showed that the month of delivery and infant birth weight were independent predictors of hepatitis B vaccination. The proportion of infants who were vaccinated in January and February 2000 (48.5% and 67.5%, respectively) was less than any other months, whereas the proportion who were vaccinated in December 2000 (88.2%) was the highest. Women who were born between 1971 and 1975 had the highest rate of rubella nonimmunity (9.5%). In-hospital postpartum rubella vaccine administration was documented for 75.6% of nonimmune women.

Conclusion. This study documents good compliance in New Hampshire's birthing hospitals with national guidelines for perinatal hepatitis B and rubella prevention and highlights potential areas for improvement.

Key Words: hepatitis B vaccine • hepatitis B surface antigen • rubella • rubella vaccine • postpartum • congenital rubella syndrome

Abbreviations: HBV, hepatitis B virus • ACIP, Advisory Committee on Immunization Practices • AAP, American Academy of Pediatrics • HBsAg, hepatitis B surface antigen • HBIG, hepatitis B immune globulin • CRS, congenital rubella syndrome • NH DHHS, New Hampshire Department of Health and Human Services • CI, confidence interval

Accepted Nov 30, 2004.


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