Hepatitis A

INFORMATION FOR WOMEN WHO HAVE HEPATITIS A DURING PREGNANCY OR BREASTFEEDING

The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What is hepatitis A?

Hepatitis A virus (HAV) causes infection and inflammation of the liver which shows up as symptoms such as fever, abdominal pain, nausea, and jaundice (yellowing of the skin). HAV is acquired from contaminated food or beverages, or through close contact with individuals who are infected. You are at risk of being infected with HAV if you travel to locations where HAV is common, if you are exposed to patients with HAV infection (for instance if you are a health care worker), or if you work with the virus in a research setting. The virus is transmitted by a fecal to oral route. Thus, infection typically results from consumption of infected food or water.

How common is hepatitis A in pregnancy?

The prevalence of HAV varies widely between countries and regions. In the United States, the virus affects approximately 1 in 1,000 pregnancies.

How is hepatitis A diagnosed?

A sample of your blood is taken and sent to a lab. Physicians diagnose HAV by detecting the presence of a particular type of antibody called HAV-specific Immunoglobulin G (IgM). An additional test called transcriptase polymerase chain reaction (RT-PCR) can detect the RNA molecule that carries the genome of HAV.

Does hepatitis A cause problems during pregnancy?

Infection with HAV causes fever from infection and inflammation of the liver leading to abdominal pain, nausea, and jaundice (yellowing of the skin). These conditions, in turn, can lead to dehydration and interfere with your nutrition. In healthy women of childbearing age, HAV is rarely fatal and usually, the disease simply runs its course with full recovery.

Does hepatitis A during pregnancy cause problems for the baby?

There is some evidence that maternal HAV infection may slightly increase the chances of premature uterine contractions and preterm labor, especially if the mother is infected during the second or third trimester. HAV in the mother also may increase the risk of placental abruption (detachment of the placenta from the uterine wall), and premature rupture of membranes (the water breaks, leading to premature labor and possibly infection). Fever caused by the infection can cause some problems for the baby, especially if the mother becomes dehydrated.

What to consider about taking medications when you are pregnant:

  • The risks to yourself and your baby if you do not treat the hepatitis A
  • The risks and benefits of each medication you use when you are pregnant
  • The risks and benefits of each medication you use when you are breastfeeding

What should I know about using medication to treat hepatitis A during pregnancy?

Fever from hepatitis A should be treated with acetaminophen or paracetamol, both of which are thought to be safe during pregnancy.

Who should NOT stop taking medication for hepatitis A in pregnancy?

Most pregnant women who need acetaminophen or paracetamol to eliminate fever from HAV infection during pregnancy should not stop taking the drug, because there is concern that fever could be harmful to the developing baby.

What should I know about choosing a medication for hepatitis A disease in pregnancy?

You may find Pregistrys expert reports about the individual medications to treat hepatitis A here and vaccines (for HAV, see Havrix and Vaqtahere. Additional information can also be found in the sources listed at the end of this report.

What should I know about taking a medication for hepatitis A when I am breastfeeding?

Acetaminophen and paracetamol are thought to be relatively safe in mothers who breastfeed.

What alternative therapies besides medications to treat hepatitis A during pregnancy?

The mainstay treatment for HAV is a preventive treatment, namely a vaccine. Hepatitis A vaccine is administered to train the immune system to recognize and defend against HAV. If you do develop hepatitis A, you should stay hydrated by drinking plenty of water. If you develop a fever, you can try to reduce it by taking a cool bath – not too cold because if it makes you shiver this can drive your fever higher.

What can I do for myself and my baby when I have hepatitis A disease during pregnancy?

Keep in mind that hepatitis A usually is a self-limiting disease. Follow your doctors instructions and stay hydrated. Furthermore, the HAV vaccine is not a live vaccine, so it is not likely to infect the developing baby. For this reason, it is recommended that pregnant women receive HAV vaccine if they are at risk of developing Hepatitis A, for instance, if they are planning to travel to a region where HAV is common, or if they sometimes eat in food establishments that may not be very sanitary. 

Resources for hepatitis A during pregnancy:

For more information about Hepatitis A during pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:

US Centers for Disease Control and Prevention: Vaccines and Pregnancy

US Centers for Disease Control and Prevention: Maternal Vaccines: Part of a Healthy Pregnancy

World Health Organization:  Hepatitis A: fact sheet 

 

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General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.


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