How To Manage Hepatitis During Pregnancy?

Hepatitis and pregnancy are never a welcome combination, but the five types of viral hepatitis we now know to exist all pose their own threats — and they're managed in different ways. What do you need to know about each of the kinds of viral hepatitis, hepatitis A, B, C, D, and E, if you are pregnant, and what doctors can do to keep you and your baby as healthy as possible if you are infected with any of them and are also expecting a baby?

Hepatitis A during pregnancy

Hepatitis A is a water-borne hepatitis virus that is mainly transmitted through contact with contaminated food and water, with either raw or improperly cooked shellfish posing a special danger. This type of viral hepatitis is more commonly found in parts of Asia, Africa, the Middle East, and Central and South America — but you can avoid the danger of contracting hepatitis A by receiving a vaccine. 

Though hepatitis A is quite prevalent, it is rarely fatal and doesn't affect pregnant women as often. If you do contract hepatitis A during pregnancy, such as if you have not had the vaccine and are traveling to particularly impacted regions, it can cause premature labor as well as, potentially, pregnancy complications such as placental abruption and your waters breaking early. Hepatitis A can also be transmitted to the baby.

Hepatitis B during pregnancy

The hepatitis B virus, which can be acute or chronic, is transmitted through infected blood, semen, or other bodily fluids. This, unfortunately, means that an infected mother can also pass hepatitis B onto her child. Because many people who live with hepatitis B do not have any symptoms, it's not uncommon for a person to have it and not be aware. There is, once again, a safe and effective vaccine for hepatitis B, and getting it will not only protect women from contracting the virus, but it also protects their babies if they become pregnant. 

While hepatitis B won't actively harm your baby during pregnancy, the risk lies in the possibility of passing the virus — which often takes a chronic, life-long, form in infants who were infected during childbirth — on during birth. If you are an expected mom with hepatitis B, your viral load should be tested at some point during your second trimester.

Hepatitis C during pregnancy

Hepatitis C can be acute or chronic as well, is responsible for countless liver cancer cases across the world, and is spread through contact with infected blood, though it is less rarely transmitted through sexual contact or from mother to baby. Because hepatitis C doesn't usually cause any symptoms in its early stages, it's quite possible to have it without knowing that anything is up with your health. Prevention is key, as there isn't currently a vaccine for hepatitis C. Pregnant women should be screened for hepatitis C if they have risk factors, like a history of drug use or receiving a tattoo in an unregulated studio. 

Hepatitis D during pregnancy

Hepatitis D is a special case — because in order to become infected with it, a person first needs to have hepatitis B. The good news is that being vaccinated against hepatitis B will also protect you against this rarer but likewise deadlier form of hepatitis. The bad news, meanwhile, is that a hep C/hep D coinfection is extremely dangerous, quickly leading to liver disease, liver cancer, and even death. 

Hepatitis D is transmitted in the same way as hepatitis B, with the World Health Organization noting that transmission from mother to child during birth is the most common scenario. If you are diagnosed with hepatitis D during pregnancy, your healthcare provider and you will discuss the best way forward in terms of treatment options as an urgent matter. While there are concerns over the use of  pegylated interferon alpha — the recommended medication for people infected with hepatitis D — the benefits may outweigh the risks for unborn babies. Babies born to mothers with hepatitis D should receive a hepatitis B vaccine along with hepatitis B immunoglobulin soon after birth, a step that will protect the baby against both hepatitis B and D. 

Hepatitis E during pregnancy

Hepatitis E is similar to hepatitis A — spread primarily through contact with contaminated water and food, it is commonly considered a "poor hygiene disease" that is more prevalent in countries or regions with inadequate sanitation. While there's a vaccine that was created in China, this hepatitis E vaccine is not available across the globe. Around half of babies born to mothers who have hepatitis E contract the virus. Rather dangerous for the unborn, hepatitis E during pregnancy has been linked to miscarriage, stillbirth, premature birth, and death after birth. Because treatment is supportive rather than active, the focus is, again, on prevention. 

Whether you are already pregnant or planning on trying for a baby, now is the time to discuss your options with your healthcare provider. Those who haven't received the hepatitis vaccines that have access to can take this step before they try to get pregnant, even if they do not consider themselves at risk. Those who have viral hepatitis already can discuss their treatment options and take timely action, and those who don't know can get tested. The rest can take steps to reduce their risk of contracting any type of viral hepatitis, protecting themselves as well as their (future) baby in the process.