Evaluation of the Newborn Metabolic Screening Form for Surveillance of Postpartum Patients for Hepatitis B Infection in New York City, 2019-2022

The New York City Department of Health and Mental Hygiene conducts surveillance of hepatitis B virus (HBV) infection among pregnant/postpartum patients. Patients are identified by multiple methods, including reporting of maternal hepatitis B surface antigen (HBsAg) status on the Newborn Metabolic Screening Form (NMSF) at the time of delivery. Health Department staff investigate reports received for HBV infection among pregnant/postpartum patients, including reports of positive HBsAg status on the NMSF, to confirm maternal HBV infection (ie, a confirmed case). We restricted this evaluation to confirmed cases that resulted in a live birth during January 2019 through June 2022 to patients with a residential address in New York City. We evaluated the utility of NMSF reports for (1) quality of demographic information, (2) the percentage of all confirmed cases that were recorded as HBsAg positive in the NMSF, (3) positive predictive value, and (4) timeliness. We received 6509 NMSF reports, of which 2575 indicated a positive HBsAg status, 1502 unknown, and 2432 missing. Among the HBsAg-positive NMSF reports, we matched 2196 to confirmed cases of HBV infection (positive predictive value, 85%). The 2196 confirmed cases with HBsAg-positive NMSF reports represented 77% of all 2864 confirmed cases of HBV infection. For 148 confirmed cases (5%), the HBsAg-positive NMSF report was the only source. Our evaluation demonstrates that the NMSF is an important supplementary reporting method for identifying pregnant/postpartum patients with HBV infection.