The pregnant hepatitis B carrier: evidence favoring comprehensive antepartum screening.

The prevalence of hepatitis B surface antigen among 15,399 gravidas screened in the prenatal clinic at Charity Hospital of Louisiana in New Orleans was 0.88%. The race-specific prevalence was 0.56% for whites, 0.62% for blacks, and 8.8% for Orientals. Identifiable risk factors could not be found for approximately half of the hepatitis B surface antigen-positive women. Comprehensive antepartum hepatitis B screening is recommended, based upon the significant risk of perinatal transmission to the neonate and upon the failure of selective screening to identify the majority of maternal hepatitis B surface antigen carriers in our population. The cost-effectiveness of general antepartum screening compares favorably with current blood bank hepatitis screening costs.