Audit of the management of pregnant women with chronic hepatitis B and their babies by the Southeast Public Health Unit (SEPHU), Victoria

The South East Public Health Unit (SEPHU) developed a model of care that included follow up of all infants born to mothers with chronic hepatitis B (CHB). This audit aimed to understand the local epidemiology of hepatitis B in pregnant women and to describe neonatal immunoprophylaxis uptake, completion of the vaccine series and post vaccination follow up of infants. All pregnant women with CHB notified between August 2022 and August 2024 residing in SEPHU catchment were extracted from Public Health Enhanced Surveillance System (PHESS). Timing and completion rates of infant hepatitis B immunoglobulin prophylaxis (HBIG) and serology were obtained from healthcare providers. Vaccination status was obtained from the Australian Immunisation Register. Descriptive and thematic analysis were conducted on baseline data and free-text notes respectively using Microsoft Excel. Ninety-seven pregnant women with CHB were notified to SEPHU. Sixty-four (66%) had delivered at time of analysis and 58 infants were followed up. Fifty-seven infants (98.3%) received HBIG, and of these 54 were within 12 h of birth as recommended. All infants received birth dose of vaccine within 24 h of birth. Of babies aged nine months and older (n = 27), ten (37%) had serology conducted after 12 months of age. A high proportion of infants received guideline-based care at birth and infant vaccination rates are at target levels, however rates of serology testing for babies over 12 months of age was low. Data were collated from various sources, highlighting the barriers and need for more streamlined approaches to monitor these indicators to further prevent mother-to-child transmission in Australia.