23 Preventing Perinatal Transmission of Hepatitis B: A Quality Assurance Review

Background Although the hepatitis B vaccination has an efficacy of 95%, the CDC reports that 275 million people are infected with chronic hepatitis B, with 700,000 deaths per year. In Ontario, a publicly-funded, 2-dose vaccine series is routinely offered to grade 7 students. However, the vertical transmission of hepatitis B is a risk for infants born to carrier mothers. Therefore, prospective mothers are routinely screened for HBsAg during the first trimester of pregnancy. The Canadian Immunization Guide recommends that all infants born to infected mothers should receive vaccine and hepatitis B immune globulin (HBIg) within 12 hours of birth. As there is no published literature on the timeliness of hepatitis B immunization, this study aimed to investigate time of HBIg and vaccine administration in infants born to HBsAg positive mothers. Objectives The primary outcome was the proportion of infants receiving HBIg and Hepatitis B vaccine within 12 hours of birth. Design/Methods Mother-infant dyads were identified where the hepatitis B vaccine was ordered. Full review was conducted for infants born to HBsAg positive mothers between 2010 and 2015. Mother and infant charts were paired and retrospectively reviewed across 6 hospital sites in Ontario, including 2 community hospitals, 2 academic hospitals, and 2 satellite teaching hospitals. Between-group differences were tested through Welch’s analysis of variance and associations were explored through Spearman’s rank correlation. Statistical significance was set for P