Diagnosis and treatment of chronic hepatitis B in women of child-bearing age and strategies for blocking mother-to-child transmission

Women with chronic hepatitis B virus ( HBV) infection face both maternal and child problems during pregnancy. One problem is to prevent hepatitis activities during pregnancy, and the other is to block mother-to-child transmission. Infants born to HBeAg-positive mothers may have a rate of chronic HBV infection of 90% if they do not receive combined immunization in time. The combination of hepatitis B vaccine and hepatitis B immunoglobulin for neonates is a safe and effective measure to prevent mother-to-child transmission of HBV.Although combined immunization is performed, infants born to HBeAg-positive mothers still have a rate of chronic HBV infection of 5%-10%. Changes in the immune system during pregnancy can increase the replication of HBV, and the activation of the immune system postpartum can lead to liver function fluctuation and aggravation of chronic hepatitis B patients. Immune failure in infants becomes the main cause of chronic hepatitis B in children and adults. Therefore, specific detection, intervention, and follow-up measures are worthy of attention and discussion for the special population of women of child-bearing age with chronic HBV infection. This article discusses the management of women of child-bearing age with chronic HBV infection before, during, and after pregnancy, the measures for effective monitoring of pregnant women and infants, and individualized therapy based on disease risk assessment and individual conditions. This article also provides reproductive and health guidance for women with chronic hepatitis B who are ready to give birth.