Screening pregnant women and vaccinating newborns to prevent hepatitis B virus (HBV) transmission from hepatitis B surface antigen-positive (HBsAg+) mothers to newborns was recommended for high-risk groups in 1984 and for all in 1988. This project studied factors relating to mothers' following the recommended schedule for their infants (hepatitis B immune globulin, three hepatitis B vaccine doses and post-vaccination antibody testing) in Dallas, Detroit, Hartford/New Haven, and Atlanta areas. During 1992-1997, 1358 HBsAg+ pregnant women were interviewed by nurses using a knowledge, attitude, practices and barriers questionnaire. In preliminary analyses of Detroit (n=129) and Dallas (n=736) data, we compared mothers whose infants were vaccinated on schedule to those whose infants failed to complete the schedule on time, controlling for area of residence, age, race, language, country of mother's birth, distance from home to provider, HBV-exposure risk practices, and understanding of survey questions. (Analyses combining all four sites are pending.) Dallas-area residence (odds ratio=2.8, p<0.02) and maternal-birth in an intermediate or high hepatitis B endemic country (odds ratio=1.6, p<0.02) were associated with on-time vaccination. Among differences identified between sites were: number of nurse home visits per mother (Dallas=0.85, Detroit=0), and delivery in private vs public hospitals (60% of enrolled Dallas women went to public hospitals; all Detroit women went to private hospitals). In conclusion, Dallas residents, a population served by home visits and receiving services in public hospitals, and women born in more highly hepatitis B endemic countries were more likely to comply with perinatal hepatitis B prevention recommendations.
Learning Objectives: Understand that lack of compliance to perinatal hepatitis B virus transmission prevention, vaccination, and post-testing is more strongly associated with programmatic characteristics than with maternal demographics; and that women born in countries with higher hepatitis B endemicity are more likely to be compliant
Keywords: Evaluation, Perinatal Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.