Hepatitis B virus serology in pregnant women: transmittal of results from obstetricians to pediatricians in California.

ABSTRACT

From late 1992 to early 1993, in order to assess the knowledge, attitudes and practice patterns of California obstetricians regarding hepatitis B virus screening of pregnant women and how maternal hepatitis B virus serologies are communicated by obstetricians to pediatricians, we mailed questionnaires to a random sample of 801 California obstetricians and 1030 California pediatricians. Response rates were 65.7% (526) for obstetricians and 71% (732) for pediatricians. Although 99.8% of the surveyed obstetricians indicated that they routinely screened all pregnant women for hepatitis B virus, their knowledge of the correct screening tests to order and their interpretation was mixed. Only 56.3% (95% confidence interval, 51.2 to 61.2) were aware of the California law and approximately 12% did not understand that it mandated universal screening of pregnant women. There was a great difference of opinion between obstetricians and pediatricians regarding how to communicate hepatitis B virus serology results on the mother. Forty-nine percent of obstetricians report that they always request the nurse to inform the pediatrician (48.6%), 51.2% always verbally inform the pediatrician, 39.1% always place an order in the mother's chart and 5.7% always send a letter to the pediatrician. In contrast only 12.9% of pediatricians responded that they always received maternal hepatitis B virus serology results from the obstetrical or nursery nurse, only 2.6% always received a verbal communication from the obstetrician, 14.1% always retrieved it from a written report in the mother's chart and 4.2% reported that they always received a letter from the obstetrician. A uniform system should be adopted to ensure efficient transmission of maternal hepatitis B serology results from obstetricians to pediatricians to ensure prompt treatment to prevent vertical transmission of hepatitis B.