In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. This sheet talks about whether exposure to hepatitis A and/or the hepatitis A vaccine may increase the risk for birth defects above that background risk. This information should not take the place of medical care and advice from your health care provider.

What is hepatitis A?

Hepatitis A is a short-term viral infection. Some of the symptoms of the disease include fatigue, nausea, vomiting, fever, abdominal pain, dark colored urine, flu-like symptoms and yellowing of the skin (jaundice). Unlike other forms of hepatitis, hepatitis A does not result in long-term liver problems. Symptoms tend to be mild in children, and can be more serious if the primary infection occurs in adulthood. Hepatitis A is the most common cause of jaundice in pregnant women.

Is hepatitis A contagious?

Yes, hepatitis A is highly contagious. The hepatitis A virus is spread through the feces of a person with hepatitis A. A person can get infected from using contaminated cooking/eating utensils, toys, and by eating contaminated food and water. Pregnant women working in a childcare setting or living in a household with an affected family member are at an increased risk for getting the disease. After coming in contact with hepatitis A, it generally takes 15 to 50 days to develop the illness.

How can I reduce my risk of becoming infected?

Good hygiene can lower the risk of infection. Always wash your hands with soap and water after using the bathroom, changing a diaper and before preparing and eating food. Boiling contaminated food or water for one minute can kill the virus.

The hepatitis A vaccine is the best protection and is thought to be effective for up to 20 years.

Hepatitis A immune globulin can also be given if you have been exposed to the virus while pregnant and have not received the vaccine. Hepatitis A immune globulin can reduce the chance that you will become infected. The immune globulin must be given within two weeks of the exposure, but should be given as soon as possible.

I think I had hepatitis A as a child. Can I develop the infection again?

Once a person has had a hepatitis A infection, they develop antibodies. These antibodies protect against infection in the future, and most individuals will not develop hepatitis A again. If a person had hepatitis A as a young child, the symptoms might have been very mild. Your health care provider can do a blood test to find out if you have had hepatitis A in the past.

I’m pregnant and I have been exposed to hepatitis A. What should I do?

The first thing you should do is talk with your health care provider. A blood test can be done to see if you have already had hepatitis A in the past, which would most likely protect you from getting it again. If the test shows that you have not had hepatitis A in the past, your health care provider may decide the hepatitis A immune globulin shot is necessary. Your health care provider may also give you the hepatitis A vaccine.

I have hepatitis A. Will it harm the baby?

The risk of transmitting hepatitis A to the baby appears to be very small, but when it does happen it can cause an infection in the liver of the developing baby. Hepatitis A is not thought to cause an increased chance for miscarriage or for birth defects. However, the infection may cause pregnancy complications such as premature labor.

Can I get the hepatitis A vaccine while I am pregnant?

The vaccine contains an inactivated, noninfectious hepatitis A virus and will not cause hepatitis A. Generally these types of vaccinations are not thought to pose a high risk to the developing baby. One small study did not show adverse effects on birth outcomes or child development. As with any medication or vaccination, the possible risks and benefits should be discussed with your health care provider. The vaccination is recommended for pregnant and non-pregnant individuals traveling to countries where hepatitis A is common. It is also recommended for some individuals working in certain high-risk professions and people who have other risk factors such as clotting-factor disorders, chronic liver disease, or use illegal drugs.

What if I have hepatitis A or the vaccine while I am breastfeeding?

Breastfeeding can continue if a mother has hepatitis A. If the mother becomes very ill or jaundiced, breastfeeding may be stopped. Also, the baby may need to be protected with gamma globulin injections so it is important to speak with your pediatrician. The mother should practice good hand washing and other hygiene.

There is no specific information on the use of this vaccine during breastfeeding; however, it is not thought that the vaccine would have any negative effects on breastfed infants. Be sure to talk to your health care provider about all your breastfeeding questions.

References Available Upon Request