When does USPSTF recommend screening for hepatitis B in pregnancy?

• A. At the first prenatal visit.
• B. Only if risk factors are present.
• C. During labor.
• D. Not routinely recommended.

Answer: (A)

Screening for hepatitis B in pregnancy is about preventing mother-to-child transmission by identifying infection early so the newborn receives protection right away. The USPSTF recommends universal testing for hepatitis B surface antigen at the first prenatal visit. Detecting infection early allows the newborn to get hepatitis B vaccine and hepatitis B immune globulin within hours of birth, which dramatically reduces the chance of the infant developing chronic hepatitis B. Testing only if risk factors are present would miss many infections, and testing during labor is too late to ensure timely neonatal prophylaxis. Not routinely screening would miss the opportunity to prevent transmission to the newborn.