Background
Methods
Design
Sample selection
Setting
Surveys
Statistical analysis
Results
Demographics
Characteristics (n = 138) | ||
---|---|---|
Age | Mean ± SD | 41.6 ± 12.3 |
Median | 39 | |
OB years in practice | Mean ± SD | 14.6 ± 10.5 |
Median | 12 | |
OB deliveries per year | Mean ± SD | 234 ± 620 |
Median | 149 | |
Gender | Male | 42 (30.4%) |
Female | 95 (68.9%) | |
Missing | 1 (0.7%) | |
Race | White, Non-Hispanic | 62 (44.9%) |
Hispanic/Latino | 7 (5.1%) | |
Pacific Islander | 1 (0.7%) | |
Black, Non-Hispanic | 2 (1.5%) | |
Asian | 57 (41.3%) | |
Other | 9 (6.5%) |
Survey responses
Questions | n (%) | ||
---|---|---|---|
(Q1) | Have you ever had a pregnant patient who tested positive for HBsAg? | Yes | 122 (88.4) |
No | 10 (7.2) | ||
Don’t know/no response | 6 (4.4) | ||
Screening | |||
(Q2) | Do you or your clinic routinely test all pregnant women for HBsAg with each pregnancy, regardless of results? | Yes | 130 (94.2) |
No | 1 (0.7) | ||
Don’t know/no response | 7 (5.1) | ||
(Q3) | Do you routinely inform HBsAg-positive pregnant women that their household and sexual contacts should be tested for hepatitis B? | Yes | 105 (76.1) |
No | 17 (12.3) | ||
Don’t know/no response | 16 (11.6) | ||
Reporting | |||
(Q4) | Do you or your clinic routinely include a lab copy of the pregnant patient’s HBsAg test result in the medical record sent to the birth hospital prior to the expected delivery date? | Yes | 89 (64.5) |
No | 33 (23.9) | ||
Don’t know/no response | 16 (11.6) | ||
(Q5) | Do you know that California state ordinance requires all physicians to report positive HBsAg test results to the county health department? | Yes | 105 (76.1) |
No | 33 (23.9) | ||
Don’t know/no response | 0 (0.0) | ||
Vaccination | |||
(Q6) | Do you routinely inform HBsAg-positive pregnant women that it is important for their newborn infants to receive hepatitis B immune globulin within 12 h of delivery to prevent perinatal hepatitis B transmission? | Yes | 124 (89.8) |
No | 2 (1.4) | ||
Don’t know/no response | 12 (8.7) | ||
(Q7) | Do you routinely inform HBsAg-positive pregnant women that it is important for their newborn infants to receive a birth dose of the hepatitis B vaccine within 12 h of delivery to prevent perinatal hepatitis B transmission? | Yes | 121 (87.7) |
No | 3 (2.2) | ||
Don’t know/no response | 14 (10.1) | ||
(Q8) | Do you routinely inform HBsAg-positive pregnant women that their infants need to receive the 2nd and 3rd doses of the hepatitis B vaccine at 1–2 months and 6 months of age? | Yes | 67 (48.6) |
No | 49 (35.5) | ||
Don’t know/no response | 22 (15.9) | ||
(Q9) | Do you routinely inform HBsAg-positive pregnant women that their infants should be tested for HBsAg and hepatitis B surface antibody between 9 and 18 months of age to ascertain whether the infants are immune or have been infected? | Yes | 28 (20.3) |
No | 78 (56.5) | ||
Don’t know/no response | 32 (23.2) | ||
Patient Education | |||
(Q10) | Do you or your clinic routinely provide educational information about hepatitis B to HBsAg-positive pregnant patients? | Yes | 67 (48.6) |
No | 30 (21.7) | ||
Don’t know/no response | 41 (29.7) | ||
Monitoring Of Hepatitis During Pregnancy | |||
(Q11) | Do you routinely measure hepatitis B DNA and/or hepatitis B e-antigen levels in HBsAg-positive pregnant patients? | Yes | 88 (63.8) |
No | 32 (23.2) | ||
Don’t know/no response | 18 | ||
(Q12) | Do you routinely monitor HBsAg-positive pregnant women by performing liver enzyme tests during pregnancy? | Yes | 107 (77.5) |
No | 14 (10.1) | ||
Don’t know/no response | 17 (12.4) | ||
Referral For Chronic HBV Management | |||
(Q13) | Do you routinely advise HBsAg-positive pregnant women to consult with a liver specialist or internist for evaluation for anti-viral therapy and lifelong monitoring for liver damage and liver cancer? | Yes | 84 (60.9) |
No | 29 (21.0) | ||
Don’t know/no response | 25 (18.1) |
Questions | N (%) |
---|---|
(Q14) Hepatitis B can lead to which of the following consequences? | |
A: Premature Death | 0 (0) |
B: Cirrhosis of the liver | 1 (0.7) |
C: Liver failure | 2 (1.4) |
D: Liver cancer | 3 (2.2) |
aE: All of the above | 130 (94.2) |
F: Don’t know | 2 (1.4) |
(Q15) About 1 in ___ foreign-born Asian and Pacific Islanders have chronic hepatitis B, as compared to 1 in 1,000 Caucasian Americans. | |
aA: 10 | 31 (22.5) |
B: 100 | 90 (65.2) |
C: 1,000 | 5 (3.6) |
D: 10,000 | 3 (2.2) |
E: 100,000 | 0 (0) |
F: Don’t know | 9 (6.5) |
(Q16) If a newborn infant is infected with hepatitis B, what is the chance that he or she will develop chronic (lifelong) infection? | |
A: 100% | 3 (2.2) |
aB: 90% | 43 (31.2) |
C: 50% | 24 (17.4) |
D: 30% | 23 (16.7) |
E: 10% | 14 (10.1) |
F: Don’t know | 31 (22.5) |
(Q17) What are the symptoms of most people with chronic hepatitis B? | |
A: Headache and fatigue | 0 (0) |
B: Nausea and vomiting | 1 (0.7) |
C: Loss of appetite | 1 (0.7) |
D: Jaundice | 2 (1.4) |
E: All of the above | 29 (21.0) |
aF: None of the above, usually none | 102 (73.9) |
G: Don’t know | 3 (2.2) |
(Q18) Without appropriate monitoring or treatment, what are the chances that a person will die from chronic hepatitis B? | |
A: 1 in 100 (1%) | 20 (14.5) |
B: 1 in 50 (2%) | 11 (8.0) |
C: 1 in 20 (5%) | 19 (13.8) |
D: 1 in 10 (10%) | 16 (11.6) |
aE: 1 in 4 (25%) | 35 (25.4) |
F: Don’t know | 37 (26.8) |
Mean number of correct responses out of 5 (standard dev.) | 3.7 (1.90) |
Knowledge | YES n(%) | NO n(%) | ra |
P
| |
---|---|---|---|---|---|
(Q13) Referral for chronic HBV management | |||||
(Q14) Complications of hepatitis B infection | correct | 80 (61.5) | 50 (38.5) | 0.05 | 0.520 |
incorrect | 4 (50.0) | 4 (50.0) | |||
(Q18) Risk of chronic HBV infection | correct | 21 (60.0) | 14 (40.0) | −0.01 | 0.904 |
incorrect | 63 (61.2) | 40 (38.8) | |||
Combination of Q14 + Q18 | correct | 20 (62.5) | 12 (37.5) | 0.02 | 0.831 |
incorrect | 64 (60.4) | 42 (39.6) | |||
(Q11) Monitoring of hepatitis B while pregnant | |||||
(Q17) Risk of newborn developing chronic infection | Correct | 33 (76.7) | 10 (23.3) |
0.18
|
0.033
|
Incorrect | 55 (57.9) | 40 (42.1) | |||
(Q6) Vaccination, HBIG | |||||
(Q17) Risk of newborn developing chronic infection | Correct | 38 (88.4) | 5 (11.6) | −0.03 | 0.700 |
Incorrect | 86 (90.5) | 9 (9.5) | |||
(Q7) Vaccination, Birth dose | |||||
(Q17) Risk of newborn developing chronic infection | Correct | 37 (86.0) | 6 (14.0) | −0.03 | 0.697 |
Incorrect | 84 (88.4) | 11 (11.6) | |||
(Q8) Vaccination, completion of series | |||||
(Q17) Risk of newborn developing chronic infection | Correct | 24 (55.8) | 19 (44.2) | 0.10 | 0.254 |
Incorrect | 43 (45.3) | 52 (54.7) | |||
(Q9) Vaccination, post vaccine serology testing | |||||
(Q17) Risk of newborn developing chronic infection | correct | 10 (23.3) | 33 (76.7) | 0.05 | 0.563 |
incorrect | 18 (18.9) | 77 (81.1) |