Recorded presentation

M. Kay Libbus, DrPH, RN¹, Lynelle Phillips, RN, MPH², and Rebecca A. Unruh, RN, BSN¹. (1) University of Missouri, MU Sinclair School of Nursing, MU Sinclair School of Nursing, Columbia, MO 65211, 573-882-0285, libbusk@missouri.edu, (2) Bureau of Vaccine-Preventable and TB Disease Elimination, Missouri Department of Health, 930 Wildwood, PO Box 570, Jefferson City, MO 6565102-0570

Without postpartum prophylaxis infants born to HbsAg mothers are highly likely to become infected leading to significant sequelae. For reported cases, Missouri public health nurse case management assures completion of the vaccination series and serology as HbsAg positive screening during pregnancy is reportable. However, CDC estimates that perinatal HepB is underreported by at least 33% in Missouri. Our study assessed the extent of HbsAg underreporting for pregnant Missourians. Patient information on 177 patients with hospital discharge codes for labor and delivery and HepB was obtained from the state hospital discharge database for 1997-2000. Of these, 101 names were not duplicated on the Missouri perinatal HepB registry and were considered potentially unreported cases. Subsequent medical record review verified cases if a positive laboratory result for HbsAg or a notation of a previous positive by the physician or nurse was found. A total of 46 cases was verified as unreported perinatal HepB. The reporting sensitivity for Missouri women with documented HbsAg in their labor and delivery medical record was 65%. The predictive value of utilizing hospital discharge codes for identifying perinatal HepB cases was 81%. These results support the CDC estimate and underscore the importance of interventions to evaluate and assure postpartum vaccination treatment.

Learning Objectives:

At the conclusions of the session the participant in this session will be able to
• Identify outcomes when perinatal hepatitis B prophylaxis is not provided.
• Discuss the role of public health nurse case management in perinatal hepatitis b control
• Evaluate the utility of medical record review in disclosing unreported cases of perinatal hepatitis b

Keywords: Perinatal Health, Hepatitis B

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation