Hepatitis A during pregnancy

By trimester

Weeks 1–13

1st trimester

Hepatitis A has not been linked to a higher birth-defect rate, but symptoms can appear 15 to 50 days after exposure. Contact your prenatal clinician quickly after a known exposure because postexposure protection works best within two weeks.

Weeks 14–27

2nd trimester

Acute hepatitis A is usually self-limited, yet fever and maternal illness have been associated with preterm labor. Hydration and liver assessment matter if nausea, vomiting, dark urine, pale stools, or jaundice develops.

Weeks 28–birth

3rd trimester

Later-pregnancy infection deserves close obstetric follow-up because preterm labor and placental separation have been reported. Rare transmission around birth has also been described, so the newborn team should know about confirmed maternal infection.

What does the evidence show for hepatitis A?

• CDC describes hepatitis A as a short-term infection whose symptoms usually appear two to seven weeks after exposure. Symptoms can include fatigue, nausea, vomiting, fever, abdominal pain, dark urine, pale stools, and jaundice. 1
• Available pregnancy studies have not shown a higher birth-defect rate after hepatitis A, but acute infection has been associated with preterm labor, particularly with fever, and placental separation has been reported. 2
• CDC advises a single-antigen hepatitis A vaccine as soon as possible and within two weeks for an unvaccinated person with a recent exposure. Immune globulin may be added according to age, immune status, chronic liver disease, and exposure circumstances. 3
• CDC reports no observed rise in maternal or infant adverse events after hepatitis A vaccination or immune globulin during pregnancy. People with increased exposure likelihood during pregnancy can receive immune globulin. 3
• CDC notes that symptoms cannot reliably distinguish hepatitis A from other viral hepatitis. Acute infection is confirmed with IgM antibody to hepatitis A virus; total antibody alone does not distinguish current infection from past infection or vaccination. 4

When should I call my provider about hepatitis A?

Seek same-day assessment for yellow skin or eyes, dark urine, clay-colored stools, persistent vomiting, inability to drink, severe abdominal pain, confusion, unusual bleeding, or marked sleepiness. During pregnancy, fever, contractions, vaginal bleeding, leaking fluid, or reduced fetal movement also requires prompt maternity-team contact because acute maternal illness can coincide with obstetric complications. Whatever the pattern, any symptom that feels beyond your usual range is a reason to call: obstetric teams expect these questions and would rather hear early than late.