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Department of Health and Human Services
Centers for Disease Control and Prevention


Vaccines & Immunizations

Maternal Hepatitis B Screening
and Reporting Requirements

** Click on each result to read the abridged text of the state immunization law.
  State Maternal HBsAg Screening Law(444) Specific Maternal HBsAg Reporting Law(445)
AL Yes[446]  No 
AK Yes[447]  No 
AZ No  No 
AR Yes[448]  Yes[449] 
CA Yes[450]  Yes[451] 
CO Yes[515]  No 
CT No  No[452] 
DC Yes[532]  Yes[531] 
DE No  No 
FL Yes[453]  Yes[454] 
GA No  No[455] 
HI Yes[456]  Yes[457] 
ID No  No 
IL Yes[458]   Yes[459] 
IN No  Yes[460] 
IA No  No 
KS Yes[461]  Yes[462] 
KY Yes[463]  Yes[464] 
LA No  Yes[465] 
ME No  No[466] 
MA Yes[467]  No 
MD No  No 
MI Yes[468]  No[469] 
MN No  Yes[516] 
MS No  No[470] 
MO Yes[471]  Yes[472] 
MT Yes[473]  Yes[474] 
NE No  No 
NH Yes[475]  Yes[476] 
NJ Yes[477]  Yes[478] 
NM No  No 
NY Yes[479]  Yes[480] 
NV Yes[481]  Yes[482] 
NC Yes[483]  Yes[484] 
ND No  No 
OH No  No 
OK Yes[485]  No 
OR Yes[517]  No 
PA Yes[486]  No 
RI No  Yes[487] 
SC No  No[488] 
SD No  No[489] 
TN Yes[490]  Yes[491] 
TX Yes[492]  Yes[493] 
UT Yes[494]  Yes[495] 
VT No  Yes[496] 
VA Yes[497]  No[498] 
WA No  Yes[499] 
WV No  No[500] 
WI No  No 
WY No  No 
   
 
[444] Does the jurisdiction require screening of pregnant women for hepatitis B infection or hepatitis B surface antigen (HBsAg)?

[445] Excluding any reporting requirement within the jurisdiction’s general disease reporting and surveillance laws, does the jurisdiction specifically require reporting of positive HBsAg status in pregnant women?

[446] For Alabama, see Ala. Admin. Code § 22-11A-16, requiring every physician or other person authorized by law to attend a pregnant woman during delivery to take or cause to be taken a biologic sample from such women to be tested for those sexually transmitted diseases for which there exists an effective vaccine.

[447] For Alaska, see Alaska Stat. § 18.15.400, requiring the certified direct-entry midwife to order a test for hepatitis at the initial prenatal visit.

[448] For Arkansas, see Ark. Code Ann. § 20-16-507, 007 26 CARR 001 and 016 24 CARR 006. Ark. Code Ann. § 20-16-507 requires that every physician or healthcare provider attending pregnant women for conditions relating to pregnancy shall take or cause to be taken from every pregnant woman they attend an approved specimen as early as possible in the pregnancy or, if not attended prenatally, then at the time of delivery. Providers shall submit such sample to an approved laboratory for a standard hepatitis B test. Every person other than a physician or health care provider who is authorized by law to provide medical treatment to a pregnant woman, and is attending a pregnant woman for conditions relating to pregnancy, but not permitted to take blood samples, shall cause an approved specimen of the pregnant woman to be taken as early as possible in the pregnancy or, if not attended prenatally, at the time of delivery, by or under the direction of a physician licensed to practice medicine and surgery and have the sample submitted to an approved laboratory for a standard hepatitis B test. 007 26 CARR 001 provides that the “Prenatal Examination for Syphilis, Human Immunodeficiency Virus and for Hepatitis B Act 963 of 1997” requires any physician and/or health care provider attending pregnant women for conditions relating to their pregnancy to test each of the women by venous blood sample for hepatitis B. 016 24 CARR 006 provides that licensed lay midwives must ensure that each client receives from a physician, CNM or division clinician, a Hepatitis B test at or near the initiation of care. Top of page

[449] For Arkansas, see 007 26 CARR 001, providing that all positive hepatitis B results obtained pursuant to the “Prenatal Examination for Syphilis, Human Immunodeficiency Virus and for Hepatitis B Act 963 of 1997” shall be reported to the Arkansas Department of Health.

[450] For California, see Cal. Health & Safety Code § 125080 and Cal. Health & Safety Code § 125085. Cal. Health & Safety Code § 125080 provides that all persons engaged in the prenatal care of a pregnant woman shall obtain a blood sample, either prior to or at the time of delivery. Cal. Health & Safety Code § 125085 provides that, as early as possible in prenatal care, a blood specimen obtained pursuant to Section 125080 shall be submitted to a specified laboratory to determine the presence of hepatitis B surface antigen, and the results shall be reported to the person engaged in the prenatal care of the woman or attending her at the time of delivery who ordered the test, and a positive test shall be reported to the local health officer. For exemptions to testing requirements, see Cal. Health & Safety Code § 125090, providing certain exceptions to maternal hepatitis B screening requirements.

[451] For California, see Cal. Health & Safety Code § 125085, requiring that positive results of hepatitis B screening test administered to a pregnant woman pursuant to Cal. Health & Safety Code § 125085 shall be reported to the local health officer.

[452] For Connecticut, no law or regulation specifically requires reporting of positive HBsAg status in pregnant women. However, see Connecticut General Statute § 19a-2a, requiring the Commissioner of Public Health to annually issue and amend as needed a list of reportable diseases and laboratory findings, and distribute it to each licensed physician and clinical laboratory in the state. The version of this list effective as of January 2005 required physicians to report HBsAg-positive pregnant women (first made reportable in 1997). Therefore, although no specific reporting requirement was written into any law or regulation, a reporting requirement with the force of law existed in Connecticut in the year this study was conducted (2005). Top of page

[453] For Florida, see 64D-3.042(1), F.A.C. and 64B-7.007(1)(a), F.A.C. 64D-3.042(1), F.A.C.provides that practitioners attending a woman for prenatal care shall cause the woman to be tested for chlamydia, gonorrhea, hepatitis B, HIV and syphilis at the initial examination related to her current pregnancy and again at 28 to 32 weeks gestation. 64B-7.007(1)(a), F.A.C. provides that the licensed midwife shall require each patient to have a complete history and physical examination which includes, among other things, screening for hepatitis B surface antigen (HBsAg).

[454] For Florida, see 64D-3.029, F.A.C., providing that practitioners must report Hepatitis B surface antigen (HBsAg)-positive in a pregnant woman to the County Health Department having jurisdiction in the area where the practitioner’s office or the patient’s residence is located by the next business day following suspicion or diagnosis.

[455] For Georgia, no law or regulation specifically requires reporting of positive HBsAg status in pregnant women. However, see Ga. Code Ann. § 31-12-2(a), providing that the Georgia Department of Human Resources is empowered to declare certain diseases, injuries, and conditions to be diseases requiring notice and to require the reporting thereof to the county board of health and the department in a manner and at such times as may be prescribed. The list of reportable diseases and conditions effective in Georgia as of January 2005 included HBsAg-positive pregnant women. Therefore, although no specific reporting requirement was written into any law or regulation, a reporting requirement with the force of law existed in Georgia in the year this study was conducted (2005).

[456] For Hawaii, see Weil’s Code of Hawaii Rules § 11-156-8.1, requiring prenatal screening of pregnant women. The attending practitioner or other person permitted by law to attend pregnant women shall submit a sample of blood from each pregnant woman to a licensed laboratory for appropriate serologic testing for hepatitis B. Top of page

[457] For Hawaii, see Weil’s Code of Hawaii Rules § 11-156-8.1, requiring that each practitioner serving as primary attendant for a pregnant woman who is a carrier of the hepatitis B virus shall report to the department’s perinatal hepatitis B program the name of the woman.

[458] For Illinois, see Ill. Admin. Code tit. 77, § 690.451 and Ill. Admin. Code tit. 77, § 350.3220. Ill. Admin. Code tit. 77, § 690.451 provides that pregnant women shall be tested for HBsAg during an early prenatal visit or when they present to a hospital for delivery if prenatal serological results are unavailable. Ill. Admin. Code tit. 77, § 350.3220 provides that every woman of child-bearing age shall receive routine obstetrical and gynecological evaluations as well as necessary prenatal care. Routine obstetrical evaluations and necessary prenatal care shall include, at a minimum, testing for viral hepatitis as early in pregnancy as possible.

[459] For Illinois, see Ill. Admin. Code tit. 77, § 690.451, providing that health care providers shall refer pregnant women who are hepatitis B surface antigen positive to a local health authority for counseling and recommendations on testing and immunizing contacts within 7 days.

[460] For Indiana, 410 IAC 1-2.3-47 (2005) requires that viral hepatitis type B in pregnant woman (acute and chronic) or a perinatally exposed infant be reported. 410 IAC 1-2.3-73 describes required follow-up and disease control measures when an infected infant or mother is detected. Top of page

[461] For Kansas, see Kan. Stat. Ann. § 65-153f, providing that each physician or other person attending a pregnant women during gestation, with the consent of such woman, shall take or cause to be taken a blood sample within 14 days after diagnosis of pregnancy is made. Such sample shall be submitted for serological tests for the detection of syphilis and hepatitis B.

[462] For Kansas, see Kan. Admin. Regs. 28-1-2, requiring cases or suspected cases of hepatitis B in pregnancy to be reported within 7 days.

[463] For Kentucky, see KY Rev. Stat. Ann. § 214.160, providing that every physician or other person legally permitted to engage in attendance upon a pregnant women shall take or cause to be taken from the woman a specimen of blood which shall be submitted for the purpose of serologic testing for the presence of hepatitis B surface antigen to a laboratory certified by the United States Department for Health and Human Services pursuant to Section 333 of the Public Health Service Act, as revised by the Clinical Laboratory Improvement Amendments (CLIA), Pub. L. 100-578.

[464] For Kentucky, see 902 KY. Admin. Regs. 2:020 Section 1(1), providing that a health professional licensed under the KY Rev. Stat. Ann., Chapters 311 through 314, and a health facility licensed under KY Rev. Stat. Ann., Chapter 216B, shall give notification pursuant to subsection (3) of this section if the health professional makes a probable diagnosis of a disease specified in Section 2, 3, or 4 of this administrative regulation and the diagnosis is supported by "Case Definitions for Infectious Conditions under Public Health Surveillance" or a reasonable belief that the disease is present. Hepatitis B infection in a pregnant woman is one of the diseases specified in Section 3 of the regulation. 902 KY. Admin. Regs. 2:020 Section 1(3) requires that the notification shall be given to the local health department serving the jurisdiction in which the patient resides; or the Department for Public Health. Top of page

[465] For Louisiana, see La. Admin. Code tit. 51, § 105, providing that Class B diseases shall require reporting within 1 business day, and identifying hepatitis B in pregnant women is a Class B disease.

[466] For Maine, no law or regulation specifically requires reporting of positive HBsAg status in pregnant women. However, see Code Me. R. § 10-144-258, providing that perinatal hepatitis B is reportable immediately to the Bureau of Health by telephone on the day of recognition or strong suspicion of disease. Maternal hepatitis B infection is not included in Maine’s list of reportable conditions.

[467] For Massachusetts, see Mass. Regs. Code tit. 105, § 130.627, providing that the obstetrics service of hospitals shall establish and maintain a system for obtaining prenatal records or summaries of records of patients during the last trimester of pregnancy and for making them available to the staff of the labor and delivery unit when the patient is admitted for delivery. The record of the mother and newborn shall include prenatal HBsAg test results.

[468] For Michigan, see Mich. Comp. Laws § 333.5123, requiring that a physician or other individual otherwise authorized by law to provide medical treatment to a pregnant woman shall take or cause to be taken, at the time of the woman’s initial examination, test specimens of the woman and shall submit the specimens to a clinical laboratory approved by the department for the purpose of performing tests approved by the department for venereal disease, HIV, and hepatitis B. If, when a woman presents at a health care facility to deliver an infant or for care in the immediate postpartum period having recently delivered an infant outside a health facility, no record of the results from the test required by this section is readily available to the physician or other individual authorized by law to provide care in such a setting, then the physician or individual otherwise authorized to provide care shall take or cause to be taken specimens of the woman and submit them for testing for venereal disease, HIV and hepatitis B. This section is inapplicable if the tests are medically inadvisable in the professional opinion of the physician or other person, or the woman does not consent to testing. Top of page

[469] For Michigan, no law or regulation specifically requires reporting of positive HBsAg status in pregnant women. Mich. Admin. Code r. 325.173 requires physicians to report each case of a serious communicable disease specified in Mich. Admin. Code r. 325.172, except for human immunodeficiency virus infection, within 24 hours of its diagnosis or discovery, to the appropriate local health department. Formerly, Mich. Admin. Code r. 132.172 identified hepatitis B infection in a pregnant woman as a “serious communicable disease.” However, the code was revised in 2008 to provide more generally that hepatitis B is a serious communicable disease. No specific mention of positive HBsAg status in pregnant women is made in the revised regulations; therefore, for the purposes of this study, Michigan is not considered to have in place a law specifically requiring reporting positive HBsAg status in pregnant women.

[470] For Mississippi, no law or regulation specifically requires reporting of positive HBsAg status in pregnant women. Section XIII of CMSR 12-000-028 (relating to perinatal hepatitis B reporting requirements and hepatitis B vaccine administration requirements for pregnant women and infants) provides that the State Board of Health declares hepatitis B to require the use of appropriate blood and bodily fluid precautions, including notification of other health care personnel, emergency medical personnel, and providers of post-mortem services as indicated by accepted standard of medial practice or required by law. Section XVII provides that a class 2 case report is required for acute viral hepatitis other than hepatitis A. The comment in Appendix B11 provides that confirmed cases are those meeting the clinical case definition and who are laboratory confirmed. Persons who have chronic hepatitis or persons identified as HBsAg positive should not be reported as having acute viral hepatitis unless they have evidence of an acute illness compatible with viral hepatitis, with the exception of perinatal hepatitis B virus infection. However, according to the Mississippi state health department, Mississippi has no legal requirement for screening or reporting maternal hepatitis B virus infection, as the phrase “perinatal hepatitis B virus infection” above refers to infection in the child. Phone conversation with Mississippi state health department, September 13, 2005.

[471] For Missouri, see Mo. Rev. Stat. § 210.030, providing that every licensed physician, midwife, registered nurse, and all persons who may undertake, in a professional way, the obstetrical and gynecological care of a pregnant woman shall, if the women consents, take or cause to be taken a sample of venous blood of such a woman at the time of the first prenatal examination, or no later than twenty days after the first prenatal examination, and subject such sample for an approved standard serological test for hepatitis B, syphilis, and such other treatable diseases as prescribed by the Department of Health and Senior Services. An approved and standard serological test for hepatitis B shall mean a test made in a laboratory approved by the Department of Health and Senior Services.

[472] For Missouri, see Mo. Rev. Stat. § 210.040 and Mo. Code Regs. Ann. tit. 19, § 20-20.020. Mo. Rev. Stat. § 210.040 provides that as soon as the result of the test is determined (see Mo. Rev. Stat. § 210.030), and if the test is positive or doubtfully positive for syphilis or hepatitis B, the physician, or other such obstetrical or gynecological attendant shall fill out a specified form and send it to the county or municipal health department of the county or city in which the pregnant woman is then residing. Mo. Code Regs. Ann. tit. 19, § 20-20.020 provides that hepatitis B surface antigen (prenatal HBsAg) in pregnant women shall be reported to the local health authority or the Department of Health and Senior Services within 3 days of first knowledge or suspicion. Top of page

[473] For Montana, see Mont. Code Ann. § 50-19-103, requiring that every female, regardless of age or marital status, seeking prenatal care from a health care provider is required to submit a blood specimen for the purpose of a standard serological test. A health care provider who attends a pregnant woman shall at the first professional visit take the blood sample and submit it to a laboratory. A person permitted to attend a pregnant woman, but not permitted to take blood samples, must have the sample taken by a person permitted to take blood samples and submit it to a laboratory. Mont. Code Ann. § 50-19-101 defines a standard serologic test as a test for syphilis, rubella immunity, and blood group, including ABO and RH (Dd) type, and a screening for hepatitis B surface antigen approved by the Department.

[474] For Montana, see Mont. Code Ann. § 50-19-105, providing that all positive laboratory tests for any sexually transmitted disease or hepatitis B surface antigen must be reported to the department by the laboratory preparing the test.

[475] For New Hampshire, see N.H. Code Admin. R. Ann., Mid 502.03, providing that, during the initial prenatal visit, the midwife shall either perform or arrange for blood analysis, including rubella titer and hepatitis B surface antigen.

[476] For New Hampshire, see N.H. Code Admin. R. Ann. He-P 301.02, providing that health care providers shall report to the Department of Health and Human Services within 72 hours following diagnosis or suspicion of diagnosis of positive B surface antigen in a pregnant woman. Top of page

[477] For New Jersey, see N.J. Admin. Code tit. 8, § 8:43G-19.2, providing that all pregnant women admitted to a hospital with unknown or undocumented hepatitis B results shall be immediately screened for the virus using a standardized screening test.

[478] For New Jersey, see N.J. Admin. Code tit. 8, § 8:43G-19.2 and N.J. Admin. Code tit. 8, § 8:57-1.3. N.J. Admin. Code tit. 8, § 8:43G-19.2 provides that all pregnant women admitted to the hospital with unknown or undocumented hepatitis B results shall be immediately screened for the virus using a standardized screening test, subject to certain time requirements. All positive test results shall be reported to the New Jersey Department of Health and Senior Services Immunization Program. N.J. Admin. Code tit. 8, § 8:57-1.3 provides that confirmed cases due to hepatitis B, including positive hepatitis B surface antigen test in a pregnant woman, should be reported within 24 hours of diagnosis.

[479] For New York, see N.Y. CLS Pub Health § 2500-e(1), requiring that every physician attending a pregnant woman must, at the time a blood sample is taken from a pregnant woman pursuant to § 2308 of this chapter for testing for syphilis, submit such sample to an approved laboratory for a standard serological test for hepatitis B. See also N.Y. CLS Pub Health § 2500-e(5), requiring that if, at the time of admission for delivery, hepatitis B surface antigen results are unavailable, the hospital shall arrange immediate testing for the mother. See also N.Y. Comp. Codes R. & Regs. § 69-3 (Pregnant Women Testing for Hepatitis B, Follow-Up Care), and N.Y. Comp. Codes R. & Regs. § 754.7 (Birth Center Services).

[480] For New York, see N.Y. CLS Pub Health § 2500-e(6), which provides that it shall be the duty of the administrative officer or other person in charge of each institution caring for infants twenty-eight days of age or less to report the hepatitis B surface antigen test results of all mothers of newborns to the New York State Department of Health. See also N.Y. Comp. Codes R. & Regs. § 69-3, requiring a health care provider attending a pregnant woman to report all positive HBsAg test results to the local health officer in accordance with section 2.10 of this Title. Top of page

[481] For Nevada, see Nev. Admin. Code ch. 441A, § 570, providing that a pregnant woman shall be screened by her health care provider for the presence of hepatitis B surface antigen. The health care provider shall refer pregnant women who are hepatitis B positive to the health care authority for counseling and recommendations on testing and immunizing contacts.

[482] For Nevada, see Nev. Admin. Code ch. 441A, § 570, providing that a pregnant woman shall be screened by her health care provider for the presence of hepatitis B surface antigen. The health care provider shall refer pregnant women who are hepatitis B positive to the health care authority for counseling and recommendations on testing and immunizing contacts.

[483] For North Carolina, see N.C. Admin. Code tit. 10A, r. 41A.0203, requiring pregnant women to be tested for hepatitis B.

[484] For North Carolina, see N.C. Admin. Code tit. 10A, r. 41A.0203, providing that pregnant women shall be tested for hepatitis B and reported in accordance with N.C. Admin. Code tit. 10, r. 41A.0101 if positive for hepatitis B infection, unless the woman is already known to be infected. N.C. Admin. Code tit. 10, r. 41A.0101 provides that hepatitis B shall be reported within 24 hours after the disease is reasonably suspected to exist. Top of page

[485] For Oklahoma, see Okla. Admin. Code § 317:30-5-176, providing that, for maternity clinics, the standard profile of routine laboratory services, e.g. rubella immunity and hepatitis B, will be completed during the initial exam.

[486] For Pennsylvania, see 28 Pa. Code § 27.99(a), relating to “prenatal examination for hepatitis B”. 28 Pa. Code § 27.99(a) provides that a physician who attends, treats, or examines a pregnant woman for conditions relating pregnancy during the period of gestation or delivery, shall inform the woman that the physician intends to take or cause to be taken, unless the woman objects, a sample of her blood at the time of the first examination (including her initial visit when a pregnancy test is positive) or within 15 days thereafter, but no later than the time of delivery, and shall submit the sample to a clinical laboratory approved by the Department to conduct immunologic testing.

[487] For Rhode Island, see R.I. Code R. 14-040-002, requiring that cases of positive hepatitis B surface antigen in pregnant women shall be reported to the Department of Health, Division of Disease Prevention and Control within 4 working days following diagnosis.

[488] For South Carolina, no law or regulation specifically requires reporting of positive HBsAg status in pregnant women. However, see SC Code § 44-29-10(A) and SC Code Regs. § 61-20. SC Code § 44-29-10(A) requires attending physicians to report cases of known or suspected contagious or infectious disease occurring within the State to the county health department, and states that the Department of Health and Environmental Control must designate the diseases it considers contagious and infectious, and may also designate other disease for mandatory reporting by physicians. SC Code Regs. § 61-20 provides that the Commissioner of the Department of Health and Environmental Control shall each year designate those diseases for which cases are to be reported by any attending physician and/or laboratories both within and outside South Carolina. This Official List of Reportable Conditions shall be issued in January of each year, and the occurrence of cases of the designated diseases shall be reported from January 1 through December 31 of that year. The Official List of Reportable Conditions effective January 1, 2005, required physicians to report positive HBsAg with each pregnancy within seven days. Therefore, although no specific reporting requirement was written into any law or regulation, a reporting requirement with the force of law existed in South Carolina in the year this study was conducted (2005). Top of page

[489] For South Dakota, no law or regulation specifically requires reporting of positive HBsAg status in pregnant women. However, see S.D. Admin. R. 44:20:02:01 and 44:20:01:04. S.D. Admin. R. 44:20:02:01 requires that a physician attending a person who has been diagnosed with or is suspected of having a reportable disease listed in § 44:20:01:03 or 44:20:01:04 shall report to the department the information required by § 44:20:02:05. Category II diseases are reportable by telephone, mail, courier, or facsimile within three days after recognition or strong suspicion of disease. S.D. Admin. R. 44:20:01:04 provides that category II reportable diseases include perinatal hepatitis B infection. Maternal hepatitis B infection is not included in South Dakota’s list of reportable conditions.

[490] For Tennessee, see Tenn. Code Ann. § 68-5-602 and Tenn. Comp. R. & Regs. 0250-4-7-.07. Tenn. Code Ann. § 68-5-602 provides that physicians, surgeons or other persons permitted by law to attend a pregnant woman during gestation shall take or cause to be taken from each such woman a blood sample at the time of the first examination and visit or within 10 days thereafter. If the first visit is at the time of delivery, or after delivery, the standard serological test shall be performed at that time. Blood samples shall be sent to a laboratory approved by the department for testing for syphilis infection, rubella immunity, and hepatitis B surface antigen. In the same manner, a sample of blood shall be taken during or after the 28th week of gestation for a woman who the attending physician determines to be at a high risk of hepatitis B or syphilis according to the current standards of care. This second sample shall be sent to a laboratory approved by the department for testing for syphilis infection and hepatitis B surface antigen. A positive test for syphilis and hepatitis shall be reported to the local health department in accordance with this chapter, and regulations governing communicable diseases in Tennessee. Every person attending a pregnant woman who is not permitted by law to take blood samples shall cause a sample of blood to be taken by a health provider permitted by law to take such samples at the time of the first examination and visit or within 10 days thereafter. These samples should be submitted to the same approved laboratories for testing for syphilis infection and hepatitis B surface antigen. Tenn. Comp. R. & Regs. 0250-4-7-.07 provides that within 2 weeks following admission to a maternity home, a complete physical examination shall be made, which shall include laboratory tests for syphilis, gonorrhea, hepatitis B virus and herpes II, tuberculin skin test, and any other special studies that may be indicated.

[491] For Tennessee, see Tenn. Code Ann. § 68-5-602 and Tenn. Comp. R. & Regs. 1200-14-1-.02. Tenn. Code Ann. § 68-5-602 provides that a positive test for syphilis and hepatitis shall be reported to the local health department in accordance with this chapter, and regulations governing communicable diseases in Tennessee. Tenn. Comp. R. & Regs. 1200-14-1-.02 provides that an HBsAg positive pregnant female must be reported to the local health officer or local health department by all physicians, laboratories, and other persons knowing of or suspecting a case in accordance with the provision of the statues and regulations governing the control of communicable diseases in Tennessee.

[492] For Texas, see Tex. Health & Safety Code § 81.090(a).Tex. Health & Safety Code § 81.090(a) requires physicians or other persons permitted by law to attend a pregnant woman during gestation or at delivery of an infant to take or cause to be taken a sample of the woman’s blood or other appropriate specimen at the first examination or visit, and to submit the sample to an appropriately certified laboratory for diagnostic testing for hepatitis B infection. Top of page

[493] For Texas, see 25 Tex. Admin. Code § 97.3(a)(2). 25 Tex. Admin. Code § 97.3(a)(2) provides that confirmed and suspected human cases of hepatitis B, (chronic) identified prenatally or at delivery as described in § 97.135 of this title (relating to Serologic Testing during Pregnancy and Delivery), are reportable.

[494] For Utah, see Utah Admin. Code R386-702-9, which provides that a licensed healthcare provider who provides prenatal care shall routinely test each pregnant woman for hepatitis B surface antigen (HBsAg) at an early prenatal care visit. The provisions of this section do not apply if the pregnant woman, after being informed of the possible consequences, objects to the test on the basis of religious or moral beliefs. The licensed healthcare provider who provides prenatal care should repeat the HBsAg test during late pregnancy for those women who tested negative for HBsAg during early pregnancy, but who are at high risk based on evidence of clinical hepatitis during pregnancy, injection drug use, occurrence during pregnancy or a history of a sexually transmitted disease, occurrence of hepatitis B in a household or close family contact, or the judgment of the healthcare provider. Every hospital and birthing facility shall develop a policy to assure that when a pregnant woman is admitted for delivery, or for monitoring of pregnancy status, the result from a test for HBsAg performed on that woman during that pregnancy is available for review and documented in the hospital record or when a pregnant woman is admitted for delivery, or for monitoring of pregnancy status if the woman's test result is not available to the hospital or birthing facility, the mother is tested for HBsAg as soon as possible, but before discharge from the hospital or birthing facility; and that positive HBsAg results identified by testing performed or documented during the hospital stay are reported as specified in this rule.

[495] For Utah, see Utah Admin. Code R386-702-9, which provides that in addition to other reporting required by this rule, each positive HBsAg result detected in a pregnant woman shall be reported to the local health department or the Utah Department of Health, as specified in Section 26-6-6.

[496] For Vermont, see VT Code R. 13-140-007, providing that hepatitis B positive surface antigen in pregnant women is required to be reported. Top of page

[497] For Virginia, see 12 Va. Admin. Code § 5-90-130, providing that every physician attending a pregnant woman during gestation shall examine and test such woman for syphilis and hepatitis B surface antigen within 15 days after beginning such attendance. A second prenatal test for syphilis and hepatitis B surface antigen (HBsAg) shall be conducted at the beginning of the third trimester (28 weeks) for women who are at higher risk for these diseases. Persons at higher risk for hepatitis B virus infection include injecting drug users and those with personal contact with a hepatitis B patient, multiple sexual partners, and/or occupational exposure to blood. If the patient first seeks care during the third trimester, only one test shall be required. Every physician should also examine and test a pregnant woman for any sexually transmitted disease as clinically indicated.

[498] For Virginia, no law or regulation specifically requires reporting of positive HBsAg status in pregnant women. Formerly, 12 Va. Admin. Code § 5-90-90 provided that physicians should report the pregnancy status of females who test positive for HBsAg, if available. However, the code was revised in 2007 to provide more generally that each physician who treats or examines any person who is suffering from or who is suspected of having a reportable disease or condition shall report (among other things) that person's name, address, age, date of birth, race, sex, and pregnancy status for females. No specific mention of positive HBsAg status is made in the revised regulations; therefore, for the purposes of this study, Virginia is not considered to have in place a law specifically requiring reporting positive HBsAg status in pregnant women.

[499] For Washington, see Wash. Admin. Code § 246-101-101, and Wash. Admin. Code § 246-101-301. Wash. Admin. Code § 246-101-101 provides that hepatitis B surface antigen in pregnant women shall be reported within 3 days by health care providers to the public health authorities. Wash. Admin. Code § 246-101-301 provides that hepatitis B surface antigen shall be reported within 3 working days by health care facilities to local departments of health.

[500] For West Virginia, no law or regulation specifically requires reporting of positive HBsAg status in pregnant women. However, see WV Bureau for Public Health, Reportable Diseases, Events and Conditions, 64CSR7, section 3, providing that perinatal hepatitis B is reportable by health care providers and health care facilities. Maternal hepatitis B infection is not included in West Virginia’s list of reportable conditions. Top of page

[515] For Colorado, see 4 CCR 739-1(5)(B)(3) (2007), providing that at the time of the initial visit for care, the registered direct-entry midwife shall arrange to or obtain laboratory testing to include among other tests: blood group and Rh type, if unknown; Coombs test for all Rh negative mothers; CBC with differential; rubella titre; serology for syphilis; and a hepatitis B screen.

[516] For Minnesota, see Minn. R. 4605.7044 (2007), providing that pregnancy in a person chronically infected with hepatitis B, human immunodeficiency virus (HIV) infection, including acquired immunodeficiency syndrome (AIDS), or other reportable perinatally transmissible diseases shall be reported to the commissioner within one working day of knowledge of the pregnancy.

[517] For Oregon, see Or. Admin. R. 333-019-0036(1)(a) (2008), providing that blood samples drawn from women during pregnancy or at delivery pursuant to ORS 433.017 shall be submitted for standard tests for reportable infectious diseases or conditions which may affect a pregnant woman or fetus. Routine tests submitted shall include syphilis, hepatitis B, and HIV. ORS 433.017 states that every licensed physician attending a pregnant woman in this state for conditions relating to her pregnancy during the period of gestation or at the time of delivery shall, as required by rule of the Department of Human Services, take or cause to be taken a sample of blood of every woman so attended at the time of the first professional visit or within 10 days thereafter. Every other person permitted by law to attend a pregnant woman in this state, but not permitted by law to take blood samples, shall, as required by rule of the department, cause a sample of blood of such pregnant woman to be taken by a licensed physician, and have such sample submitted to a licensed laboratory for the tests described under subsection (1) of this section.

[531] For Washington DC, see 22 DCMR § 207, relating to hepatitis B testing and vaccination, and 22 DCMR § 201, relating to communicable diseases. 22 DCMR § 207.1(d) provides that a provider that attends to, treats, or examines a pregnant woman or provides perinatal treatment shall make a report according to the requirements of section 201.5. 22 DCMR § 201.5 provides that infectious and serum hepatitis shall be considered a communicable disease and shall be reported in writing within forty-eight (48) hours of diagnosis or the appearance of suspicious symptoms in the manner indicated in § 200 of chapter 2 of this title. Because 22 DCMR § 207.1 relates specifically to providers attending, treating or examining pregnant women or providing perinatal treatment, for the purposes of this study, Washington DC is considered to have in place a law specifically requiring reporting positive HBsAg status in pregnant women.

[532] For Washington DC, see 22 DCMR § 207, relating to hepatitis B testing and vaccination. 22 DCMR § 207.1 provides that a provider that attends to, treats, or examines a pregnant woman or provides perinatal treatment shall take a blood sample during the first prenatal visit and submit the sample to a laboratory approved by the Department for testing for Hepatitis B Surface Antigen (HBsAg), or take a blood sample at the time of delivery if the woman has not had prior perinatal services or no documentation of HBsAg status, and submit the sample to a laboratory approved by the Department for testing HBsAg.

Disclaimer: The purpose of this database is to provide researchers, policymakers, and state and local public health practitioners with descriptive information concerning state immunization-related law. No part of this legal analysis involves providing legal advice or answering specific questions of law on behalf of any person or organization.

This page last modified on January 11, 2011
Content last reviewed on December 15, 2009
Content Source: National Center for Immunizations and Respiratory Diseases

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