Pregnancy and HIV, Viral Hepatitis, STD, & TB Prevention

All pregnant women should be tested for hepatitis B surface antigen (HBsAg) and those testing positive should be tested for HBV DNA. If a pregnant woman is infected, hepatitis B virus transmission to her infant can be prevented by providing HBV immune globulin and hepatitis B vaccine to the infant within 12 hours after birth, followed by the completion of the 3-dose vaccine series.

Health care providers should assess all persons for risk factors associated with hepatitis C virus infection—including pregnant women—and test those who might be at risk. While screening for HCV is not recommended for all pregnant women, the increase in cases of acute HCV among men and women of reproductive age has elevated the concern, emphasizing potential perinatal HCV transmission. However, no curative treatment has been determined to be safe for use by pregnant women or infants, and no recommended interventions are available for preventing perinatal transmission.

All pregnant women should be tested for HIV as early as possible, preferably at the first prenatal visit. The earlier HIV is diagnosed and treated, the more effective HIV medicines — called antiretroviral therapy or ART — can be at preventing transmission and improving the health outcomes of both mother and child.

All pregnant women should be tested for syphilis at the first prenatal visit, ideally during the first trimester of pregnancy. The earlier syphilis is diagnosed and treated during pregnancy, the more likely congenital syphilis and its complications (such as stillbirth) can be prevented in the infant. Penicillin G is effective for preventing maternal transmission to the fetus, as well as treating fetal and maternal infection. Women who live in areas of high syphilis morbidity or who have personal or partner risk for syphilis should be screened again early in the third trimester and at delivery.

Healthcare providers should assess all persons, including pregnant women, for risk factors associated with latent TB infection and TB disease. While universal testing for latent TB infection and TB disease is not recommended for pregnant women in the United States, targeted testing for those with risk factors, including women living with HIV infection, women born in high TB prevalence countries, and those who are known contacts of persons with TB disease, facilitates prompt initiation of curative treatment for those with TB disease.