CHAPTER 26 Maternal infections
Viral disorders
Hepatitis B
Prophylaxis
• For babies born to HBsAg-positive mothers, the generally accepted approach is to give the baby hepatitis B immunoglobulin (100 IU, intramuscular, in Australia) as well as the hepatitis B immunisation in the opposite limb. Immunoglobulin should ideally be given before 12 hours of age. This regimen results in >90% protection.
• Before commencing the above schedule, it should be discussed with the parents, or at least the mother, when possible. However, if the mother is unavailable (e.g. after a general anaesthetic), the immunoglobulin should be given anyway. This is just as important as treating pneumonia with antibiotics.
Immunisation
• In Australia, this begins at birth and the dose is 5 μg, given by intramuscular injection. Other countries use 10 μg.
• Immunisation should be administered in hospital prior to discharge (when the baby is ‘physiologically stable’) and preferably in the first 24 hours of life.