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?
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 Vaqta) here. 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