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Proposal for routine antenatal screening at 14 weeks for hepatitis B surface antigen

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7014.1197 (Published 04 November 1995) Cite this as: BMJ 1995;311:1197
  1. P M Grosheide, research physiciana,
  2. J W Wladimiroff, professorb,
  3. R A Heijtink, virologistc,
  4. J A Mazel, general practitionerd,
  5. G C M L Christiaens, obstetriciane,
  6. A S M Nuijten, obstetricianf,
  7. S W Schalm, professor of medicinea
  1. aDepartment of Internal Medicine II, University Hospital Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands,
  2. bDepartment of Obstetrics, University Hospital Dijkzigt, Rotterdam
  3. cDepartment of Virology, Erasmus University, Rotterdam
  4. dPrins Bernhardlaan 43, 7622 BE Borne
  5. eDepartment of Gynaecology and Obstetrics, Academic Hospital, Utrecht
  6. fState School of Training for Midwives, Rotterdam
  1. Correspondence to: Professor Schalm.
  • Accepted 25 July 1995

Abstract

Objective: To develop a low cost, high compliance screening programme for identification of carriers of hepatitis B surface antigen in the obstetric population of the Netherlands.

Design: A seven year open, descriptive study of screening for hepatitis B surface antigen as part of routine prenatal laboratory testing at 14 weeks of gestation. Compliance with programme evaluated by checking delivery records (hospitals) or registration of births in the 30 participating municipalities (rural area).

Setting: Three large city hospitals (two tertiary referral centres) and one rural area with a large number of home deliveries.

Subjects: 99706 pregnant women applying for prenatal care for the first time.

Main outcome measures: Proportion of pregnant women routinely screened; prevalence of hepatitis B surface antigen in large cities and rural area.

Results: Uptake of screening reached 97% in the hospitals after inclusion of 10% screened at delivery; the estimated uptake in the rural area was >95%. Prevalence of hepatitis B surface antigen was 1.6% in the large cities and 0.3% in the rural area. For screening at delivery the prevalence was 2.5 times higher (4%, P<0.01) than for screening at week 14 of gestation.

Conclusion: Incorporation of universal testing for hepatitis B surface antigen into routine prenatal laboratory testing is practical; high compliance is achieved when screening is supplemented with rapid screening at delivery for those who escaped routine prenatal care.

Footnotes

  • Funding The Praeventiefonds, the Netherlands.

  • Conflict of interest None.

  • Accepted 25 July 1995
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