Document Type
Article
Publication Date
9-30-2017
Abstract
Background: In pregnant women with high viral loads, third-trimester initiation of antiviral agents can reduce the risk of vertical transmission. We aimed to assess obstetricians' and gynecologists' (OB-GYN) knowledge and clinical practice when treating pregnant women with chronic hepatitis B virus (HBV).
Methods: All program directors (PDs) from 250 US OB-GYN residency programs were invited to anonymously complete an 18-item questionnaire. Descriptive statistics were calculated and analyzed.
Results: A total of 323 participants responded, including both PDs (n=51, response rate 21%) and residents (n=272, response rate 11%). Responding PDs (62% university-based vs. 32% community-based) came from various practice types. All PDs and 95.2% of residents reported screening for chronic HBV in pregnant patients on the first prenatal visit. A majority of PDs (85.5%) and residents (85%) correctly interpreted HBV serologies. Referral patterns showed that 66.7% of PDs and 65.5% of residents refer to a specialist regardless of viral load. A minority of respondents (19.6% PDs and 12.6% residents) knew that third-trimester antiviral therapy is recommended for women with high viral loads (>200,000 IU/mL). Few respondents had prescribed HBV antivirals (9.8% PDs and 6.0% residents), with residents more commonly prescribing tenofovir and less frequently lamivudine. Half the PDs believed trainees from their programs were comfortable managing HBV in pregnancy, but only 41.8% of residents reported being comfortable managing pregnant patients with HBV.
Conclusion: OB-GYNs report screening almost all pregnant patients for chronic HBV, though significant gaps still exist in practitioner comfort and training regarding the management of HBV during pregnancy.
Recommended Citation
Niu, Bolin; Halegoua-De Marzio, Dina; Fenkel, Jonathan M.; and Herrine, Steven K., "Obstetricians' and gynecologists' knowledge, education, and practices regarding chronic hepatitis B in pregnancy." (2017). Division of Gastroenterology and Hepatology Faculty Papers. Paper 78.
https://jdc.jefferson.edu/gastro_hepfp/78
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.
PubMed ID
29118562
Language
English
Comments
This article is the authors’ final published version in Annals of Gastroenterology, Volume 30, Issue 6, September 2017, Pages 670–674.
The published version is available at https://doi.org/10.20524/aog.2017.0196. Copyright © Niu et al.