Pregnancy screening 2017

Pregnancy screening, 2017

In 2017, a total of 64,059 blood type analyses were performed in pregnant women. Among these women, 64,038 (99.9%) were tested for hepatitis B, 63,928 (99.8%) for HIV and 62,914 (98.2%) for syphilis.

Pregnant women with hepatitis B infection

Of the 64,038 tested pregnant women, a total of 132 (0.21%) were HBsAg positives, which is at par with the level observed in previous years. A positive HBsAg (hepatitis B surface antigen) indicates a current acute or chronic hepatitis B virus infection.

Among these, 56 (42%) women tested positive to HBsAg for the first time in 2017.

The remaining 76 women (58%) had already tested HBsAg positive at previous testing sessions.

The Department of Infectious Disease Epidemiology and Prevention at the SSI sends out reminders for notification of hepatitis B if no current or previous notification has been made. Therefore, all except for two pregnant HBsAg positives were reported to the statutory national notification system in 2017. HBeAg, a marker for disease activity associated with an increased risk of intrauterine mother-to-child transmission, was detected in 10 (8%) of the women.

As in previous years, the majority of HBeAg-positive women were from South-East Asia, Table 1. No women of Danish origin were HBeAg-positive.

Since the introduction of the general screening for hepatitis B, the number of children infected with hepatitis B at birth in Denmark has decreased considerably, Figure 1. In 2016 and 2017, no children below 18 years of age were notified as having become infected at birth in Denmark.

HIV-positive pregnant women

Among the 63,928 pregnant women who were tested for HIV, 33 (0.05%) tested positive.

A total of eight women had newly detected HIV and 25 were known HIV positives.

Among the newly detected HIV-positive pregnant women, five were from Africa, two were from Thailand and one was from Denmark, Table 4. Two had immigrated in 2015 and one had emigrated in 2004, 2011, 2012 and 2013, respectively. For one person, the time of immigration remained unknown.

All newly detected HIV-positive pregnant women were notified via the statutory national HIV notification system.

The 2017 pregnancy screening detected two HIV-positive women of African origin who had previously tested negative in the pregnancy screening. One of the women tested negative during a pregnancy in 2015, but subsequently tested positive in the 2017 pregnancy screening. The child from her pregnancy in 2015 subsequently tested positive for HIV, which means that the mother had become infected with HIV during her first pregnancy.

The other woman was tested for HIV in her 39th week due to symptoms. She tested HIV positive at this time after having tested HIV negative in the beginning of her pregnancy.

Pregnant women with syphilis

Among the 62,914 pregnant women who were screened for syphilis in 2017, 96 tested positive. The majority of these women were false positives or had antibodies from previous syphilis. The confirmatory test makes it possible to identify both the false positives/previously infected cases and the pregnant women who currently have syphilis. Confirmatory serological tests were performed in 95 of the women (99%). Current syphilis was established in ten of these cases, corresponding to 0.02% of all the screened pregnant women.

Of the ten positives, eight were of Danish origin, and one was from Africa and Eastern Europe, respectively.

All ten women were notified via the statutory national syphilis notification system.

One woman did not have the confirmatory test performed despite several requests from the SSI to do so.

No cases of congenital syphilis were notified during 2017.

This report is also described in EPI-NEWS 36/18.