Pregnancy screening 2018

Screening of pregnant women, 2018

In 2018, a total of 63,179 blood type analyses were performed in pregnant women. Among these women, 63,158 (99.9%) were tested for hepatitis B (HBV), 63,080 (99.8%) for HIV and 63,135 (99.9%) for syphilis.

Pregnant women with hepatitis B infection

Of the 63,158 tested pregnant women, a total of 153 (0.24%) were HBsAg positives (hepatitis B surface antigen), which is at par with the level observed in previous years. A positive HBsAg indicates a current acute or chronic hepatitis B virus infection.

Among these, 69 (45%) women tested positive to HBsAg for the first time in 2018. The remaining 84 women (55%) had already tested HBsAg positive at previous testing sessions.

The Department of Infectious Disease Epidemiology and Prevention at the SSI sends out reminders to doctors for registration of hepatitis B if no current or previous notification has been made.

Therefore, all cases were registered in the statutory national notification system in 2018.
HBeAg, a marker for disease activity associated with an increased risk of intrauterine mother-to-child transmission, was detected in 12 (8%) of the women.

As in previous years, the majority of HBeAg-positive women were from South-East Asia, Table 1.

Since the introduction of the general screening for hepatitis B in 2005, 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. In 2018, a child aged 16 years (born before the introduction of the general screening) was notified as having become infected at birth in Denmark.

HIV-positive pregnant women

Among the 63,080 pregnant women who were tested for HIV, 32 (0.05%) tested positive.

A total of five women had newly detected HIV and 27 were known HIV positives.

Among the newly detected HIV-positive pregnant women, four were from Africa and one was from Denmark, Table 2. Two had immigrated in 2014 and 2017, respectively, and should therefore have been offered an HIV test upon their arrival to Denmark, cf. the guidelines from the Danish Health Authority.

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

Pregnant women with syphilis

Among the 63,135 pregnant women who were screened for syphilis in 2018, 109 tested positive. The majority of these women were false positives or had antibodies from previous syphilis.

Confirmatory serological tests were performed in 108 of the women (99%). The confirmatory test makes it possible to identify both the false positives/previously infected cases and the pregnant women who currently have syphilis. Current syphilis was established in 21 of these cases, corresponding to 0.03% of all the screened pregnant women.

Among the 21 positives, 12 were of Danish origin, four were from South-East Asia, two from Brazil, and one was from Russia, the Congo and Greenland, respectively.

Only ten of the 21 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 in 2018.

Double infections

Double infection was reported in three pregnant women; two with HIV and HBV and one with HBV and syphilis.

This report is also described in EPI-NEWS 21/19.