Hepatitis and Pregnancy: What to Know

Hepatitis is a type of infection that can seriously damage your liver. And if you’re pregnant, you can pass it on to your newborn.

You can have one of the three most common types of hepatitis viruses -- A, B, and C -- and not know it. Usually, it won’t hurt your unborn baby or affect your pregnancy. If your doctor knows you have it, or might have it, she can help you manage it during your pregnancy to lower the chances of any long-term liver disease for you and your baby.

Hepatitis C (HCV)

You catch this virus through contact with blood. Today, most Americans get it after sharing needles or other tools to inject drugs. HCV is showing up in more and more pregnant women, probably because of the sharp rise in heroin and prescription drug abuse.

How HCV Affects Your Baby

One in 20 infants born to mothers with HCV gets the virus. That can happen in the womb, during delivery, or after the baby is born. The disease usually does not affect your baby before birth. Your child can’t catch the virus from your breast milk, but check with your doctor if your nipples are cracked or bleeding since the virus spreads through blood.

There’s no way to prevent the virus from spreading to your baby. You don’t need to deliver by cesarian section just because you have hepatitis C.

Test and Care

Most doctors recommend testing a baby for hepatitis C after they’re 18 months old. Checking before then isn’t useful because a very young infant still carries his mother’s antibodies to HCV. A test would show that the baby is infected when he might not be.

What You Can Do

Doctors don’t regularly test for hepatitis C during pregnancy. If you have any reason to think you might have it -- because you’ve used drugs or had sex with someone who has the disease, for example -- get tested. Do it even if you feel fine. Four out of 5 people with HCV don’t have any symptoms.

Your doctor likely won’t treat you for hepatitis C while you’re pregnant because the medications can cause birth defects.

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Hepatitis B (HBV)

Like hepatitis C, this virus can cause serious infections that damage the liver. You can pass both viruses to your baby before, during, or after vaginal or C-section delivery. The difference with hepatitis B is that:

  1. You can get it not only through blood, but less likely through semen, vaginal discharge, saliva, and other body fluids.
  2. A vaccine can prevent HBV infection, and most babies get it at birth.
  3. Doctors regularly test pregnant women for it.
  4. If you’re infected, the chances of passing it to your baby are much higher than for hepatitis C. If you’ve gotten sick with hepatitis B in the last 6 months, what your doctor may call acute infection, your newborn has a 90% chance of getting it. If you’ve had the infection for longer, called chronic hepatitis B, that chance drops to 10-20%.

Care After Delivery

There’s no cure for hepatitis B. But if your newborn gets his first dose of the hepatitis B vaccine and another shot called hepatitis B immune globulin within 12 hours, he has better than a 90% chance of never getting the virus. All babies routinely get the first shot. But they get the immune globulin only if the mother has or is suspected of having HBV. The baby also needs two remaining doses of the vaccine over the next 6 months to get maximum protection.

You can safely breastfeed if you have hepatitis B.

Hepatitis A (HAV)

This is a much milder form of hepatitis than the other two types. But it’s the only one that can causes serious problems during your pregnancy.

You usually get hepatitis A by eating or drinking something that has had contact with an infected person’s poop, such as through dirty hands during food prep. Most people recover on their own without treatment. It’s rare for pregnant women to pass it to her child.

But HAV can make you go into labor too early, especially if you get the virus after your first trimester. It can lead to other dangerous complications, such as causing your placenta to separate from your uterus before your baby is ready to be born.

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What You Can Do

Hepatitis A is more common in places without clean food and water and with poor sanitation systems. If you are pregnant or of childbearing age, consider getting an HAV vaccine before you visit those areas. If you’ve eaten at a restaurant that reported a hepatitis A outbreak, see your doctor. A vaccine can help protect you and your unborn baby. But you need to get it within 2 weeks of getting the virus.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on September 06, 2019

Sources

SOURCES:

CDC: “Hepatitis A Questions and Answers for the Public,” “Hepatitis B FAQs for the Public,” “Protect Your Baby for Life: When a Pregnant Woman has Hepatitis B,” “Hepatitis C FAQs for the Public,”  “Hepatitis C Virus Infection Among Women Giving Birth -- Tennessee and United States, 2009-2014.”

Mayo Clinic: “Hepatitis A,” “Hepatitis C.”

Medscape: “Hepatitis in Pregnancy.”

UpToDate: “Patient education: Vaccination during pregnancy (Beyond the Basics).”

Canadian Family Physician: “Hepatitis A infection during pregnancy.”

The American College of Obstetricians and Gynecologists: “Hepatitis B and Hepatitis C in Pregnancy,” “Routine Tests During Pregnancy.”

Hepatitis B Foundation: “Pregnancy and Hepatitis B.”

Paediatrics Child Health: “Hepatitis C in Pregnancy.”

Clinical Liver Disease: “Viral Hepatitis and Liver Disease.”

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