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The midwife calls you to assess a newborn in the delivery room. The pregnancy was uneventful, but the mother's serology results show the following: hepatitis B surface antigen (HBsAg) negative, antibodies against hepatitis B surface antigen (anti-HBs) negative, but antibodies against hepatitis B core antigen (anti-HBc) positive. You wonder if the baby is at risk for perinatal transmission of hepatitis B virus (HBV) requiring preventive measures at this time.
Structured clinical question
Does a newborn of a mother with isolated antibodies against hepatitis B core antigen need immunisation (intervention) to prevent perinatal infection with HBV (outcome)? If yes, what type and timing of immunisation?
Search strategy and outcome
We searched MEDLINE via PubMed (January 1950 to November 2013) for the following terms: “anti-HBc AND vertical transmission”, “anti-HBc AND vaccination AND newborn”, “vaccination AND newborn AND perinatal transmission AND hepatitis B”, “isolated antibody AND hepatitis B AND pregnancy/pregnant”. Two hundred and forty-three abstracts were screened, 11 were considered for full text review. Of those, four were eligible and seven were excluded: four did not address the main question, two provided no follow-up data …