Prevalence of hepatitis B virus infection among pregnant women attending prenatal care at Mae Sai Hospital in the border regions of northern Thailand
Main Article Content
Abstract
Background: Hepatitis B virus (HBV) infection is a major public health problem worldwide and a major cause of liver diseases. Pregnant women with HBV infection are reservoir for the virus to transmit it to their child. Most infants (90%) who are infected with HBV will develop chronic infection and 25% will die prematurely from liver cancer or cirrhosis.
Objectives: To assess the prevalence of HBV infection among pregnant women attending prenatal care at Mae Sai Hospital, a border region in Northern Thailand.
Materials and methods: This retrospective cross-sectional research study collected data from the hospital records database between January 2019 and September 2023. All pregnant women were tested for serum HBsAg marker by the STANDARD Q HBsAg Test. Statistical analyses were conducted using IBM SPSS version 29.0, with logistic regression used to detect the associations between variables at a significance level of p<0.05.
Results: The study population comprised 2962 pregnant women, with 29.98% Thai and 70.02% non-Thai divided into Burmese (48.12%) and other ethnic groups (51.88%). The overall prevalence rate of HBV infection among pregnant women was 4.9% (95%CI=4.1-5.7). The HBV prevalence rates of Thai pregnant women and non-Thai pregnant women were 2.9% (95%CI=1.8-4.2) and 5.7% (95%CI=4.7-6.9), respectively. Two variables (nationality and year of birth) were associated with hepatitis B infection. Non-Thai pregnant women had a 2-fold (95%CI=1.998-3.161, p=0.003) greater chance of HBV infection than Thai pregnant women, while Thai pregnant women born before the implementation of the national vaccination program had a 4.2-fold (95%CI=1.757-10.037, p=0.004) greater chance of HBV infection than those born after the program implementation.
Conclusion: This study found a lower prevalence of hepatitis B virus infection in pregnant women compared to previous studies. Only born vaccination was an associated factor with hepatitis B infection. It is essential to raise awareness, promote preventive measures, and implement screening before pregnant planning or receiving HBV vaccine to stop the infection during pregnancy leading to stop transmitting of hepatitis B to their children.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
References
World Health Organization. Hepatitis B WHO website.2024 [Cited 2025 Mar6]. Available from: https://www.who.int/publications/i/item/9789240091672.
Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015; 385(9963): 117-71.
World Health Organization. WHO Guidelines on Hepatitis B and C Testing. Geneva: World Health Organization; 2017 Feb. 4, BACKGROUND – EPIDEMIOLOGY AND NATURAL HISTORY. [cited 2025 Mar6]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442290/.
Shapiro CN. Epidemiology of hepatitis B. Pediatr Infect Dis J. 1993; 12(5): 433-7. doi: 10.1097/00006454-199305000-00036.
Piratvisuth T. Optimal management of HBV infection during pregnancy. Liver Int. 2013;33(1):188-94. doi:10.1111/liv.12060.
Chang MH, Chen DS. Prevention of hepatitis B. Cold Spring Harb Perspect Med. 2015; 5(3): 021493. doi: 10.1101/cshperspect.a021493.
World Health Organization. Hepatitis B WHO web-site. 2024. [cited 2025 Mar6]. Available from:https://www.who.int/news-room/fact-sheets/detail/hepati-tis-b.
Posuwan N, Wanlapakorn N, Sintusek P, Wasitthankasem R, Poovorawan K, Vongpunsawad S, Poovorawan Y. Towards the elimination of viral hepatitis in Thailand by the year 2030. J Virus Erad. 2020; 6(3): 100003. doi: 10.1016/j.jve.2020.100003.
Department of Disease Control, Ministry of Public Health. Thailand National Strategies to Eliminate Viral Hepatitis 2022-2030. [cited 2025 Mar6]. Available from: chrome-extension://
efaidnbmnnnibpcajpcglclefindmkaj/https://www.globalhep.org/
sites/default/files/content/resource/files/2023-02/Book%20Strategies%20to%20Eliminate%20Viral%
20Hepatitis%202022%20%E2%80%93%202030%20Po7.pdf
Poopaibool N. Prevalence of hepatitis B viral infection in pregnant women on the Thailand-Myanmar border.Sawanpracharak Medical Journal. 2020; 7(2): 151-63(in Thai).
Banks T, Kang J, Watts I, Tyrosvoutis ME, Min AM, Tun NW, Keereecharoen L, Simmawong W, Wanyatip S, Hanboonkunupakarn B, Nosten F, McGready R. High hepatitis B seroprevalence and risk factors for infection in pregnant women on the Thailand-Myanmar Border. J Infect Dev Ctries. 2016; 10(4): 384-8. doi: 10.3855/jidc.7422.
Ahamed M S, Chaklader T, Hossain S, Farah S, Ali M, Shahnaz F. Prevalence of hepatitis B infection among the pregnant women of forcibly displaced Myanmar Nationals in a selected Rohingya camp. J Dhaka National Med Coll Hos. 2023; 29(02): 32-7. doi: 10.5281/zenodo.10241439.
Umer A, Teklemariam Z, Ayele F, Mengesha MM. Prevalence of hepatitis B infection and its associated factors among pregnant mothers attending antenatal care at public hospitals at Hararghe, Eastern Ethiopia. Front Glob Womens Health. 2023; 27(4): 1056488. doi: 10.3389/fgwh.2023.1056488.
Deng Q, Lin L, Guo W, Deng X, Zhang Q, Hou J. Prevalence of hepatitis B virus infection among pregnant women in the mountainous regions of southern China: A retrospective single-center study. J Clin Lab Anal. 2023; 37(2): e24837. doi: 10.1002/jcla.24837.
Porngasemsart Y, Sirilert S, Tongsong T. Change in prevalence of hepatitis B virus infection in pregnant women in the last two decades in Thailand. Viruses. 2024; 16(2): 314. doi: 10.3390/v16020314.
Harnkuno K, Phukwapee D, Somsorn S, Wattanatorn S. Factors associated of hepatitis B virus infection in pregnant women in Pathum Thani, 2018. Office of Disease Prevention and Control Region 7 Saraburi. 2021; 28(2): 11-20 (in Thai).
Surakan P, Yotha N, Simatan S. Prevalence of hepatitis B virus infection in pregnant women, Health Region 7. Office of Disease Prevention and Control Region 7 Khon Kaen. 2020; 29(1): 24-30 (in Thai).
Shakeri H, Rahmanian V, Shakeri M, Mansoorian E. Study of anti-Hbs antibody titer and associated factors among healthcare staff vaccinated against hepatitis B more than ten years in hospitals of Jahrom In 2016. Pharmacophore. 2018; 9: 156-61.
Sehmen E, Yılmaz EM, Oruç MA. Investigation of hepatitis B surface antibody levels in adults with routine hepatitis B vaccination in childhood. Viral Hepat J. 2023; 29(2): 70-4. doi: 10.4274/vhd.galenos.2023.2023-4-6.