Antenatal infectious disease screening
When you're pregnant, your midwife will offer you a screening blood test to check for HIV, hepatitis B, and syphilis infections and for susceptibility to rubella virus. As these conditions could affect your health and the health of your baby, screening is recommended to allow earlier diagnosis and treatment.
Antenatal infectious disease screening will continue throughout the coronavirus (COVID-19) outbreak as part of your routine antenatal care. Additional advice for pregnant women and parents in Northern Ireland is available on the NI Maternity website
Agreeing to screening
When you’re between eight and 12 weeks pregnant, you’ll have your first antenatal appointment. The screening blood test is part of the booking bloods offered at this appointment.
Only one blood sample is needed for all four tests (HIV, hepatitis B, syphilis infections and susceptibility to rubella).
You can decline to have any of these screening tests. If you decline a screening test, it will be offered again later during your pregnancy.
If you want more information about the tests, ask the doctor or midwife at the clinic. The tests and your results are confidential.
Susceptibility to rubella
This test checks if you’re susceptible (not immune) to the rubella virus, also known as German measles. Most adults in Northern Ireland are vaccinated and immune (not susceptible) to the virus.
If you’re not immune, you should avoid contact with anyone who has rubella when you’re pregnant.
Infection with rubella in early pregnancy, could cause your unborn baby to get congenital rubella syndrome (CRS). This can damage their:
- sight
- hearing
- brain
- heart
If you’re over four months pregnant, rubella is unlikely to affect your baby.
If you come into contact with someone who has rubella, you should tell your doctor immediately. They can arrange a blood test to check if you are infected.
Protection if you’re not immune to rubella
If your screening test shows that you're not immune to rubella, you will be offered two doses of the MMR (measles, mumps and rubella) vaccine after your baby has been born.
MMR cannot be given during pregnancy, however vaccination after your baby is born will protect you from infection in future pregnancies.
You will be offered the MMR vaccination before you are discharged from hospital after your baby is born and your doctor will then offer you a second MMR at least four weeks later.
It’s important you don’t become pregnant for a month after getting the MMR vaccine.
Syphilis
This test checks if you have syphilis, a sexually transmitted infection (STI).
If you’re pregnant and have syphilis, you could pass the infection to your unborn baby during pregnancy or delivery. This is more likely to happen in the early stages of your infection.
How syphilis can affect a baby
Syphilis increases the risk of:
- miscarriage
- stillbirth
- premature birth
If you’re infected with syphilis, and stay untreated there is an increased risk your baby will have congenital syphilis, a lifelong illness.
Treating syphilis during pregnancy
If your screening test is positive for syphilis you will be reviewed by a specialist doctor who will advise on and oversee your treatment and follow up care.
By treating syphilis early, there is less risk of permanent damage to your health and your baby’s health.
When your baby is born, a doctor will take their blood and check for signs of congenital syphilis. The doctor will give your baby antibiotics if necessary.
Hepatitis B
Hepatitis B is a virus that can cause liver disease. It can be transmitted:
- through close sexual contact
- through injecting drugs
- through contact with infected blood
- from mother to baby during pregnancy
If you have the virus or become infected during pregnancy, your baby is at risk of developing congenital hepatitis B. This is a long-term condition that can lead to liver disease.
Treating hepatitis B during pregnancy
If your screening test is positive for hepatitis B you will be reviewed by a specialist doctor who will advise on and oversee your treatment and follow up care. They might prescribe antiviral drugs to take later in pregnancy.
When your baby is born, they will be offered a hepatitis B vaccine to reduce their risk of becoming infected.
Vaccinating against hepatitis B infection
Your baby will be offered a hepatitis B vaccine at:
- birth
- one month old
- one year old
Your baby will also get a hepatitis B vaccination at two, three and four months along with their other routine vaccinations.
Human Immunodeficiency Virus (HIV)
This test detects the virus that can cause AIDS. If you’re infected with HIV, you could pass the infection to your baby during:
- pregnancy
- childbirth
- breastfeeding
How HIV can affect your health
HIV damages your immune system. Without treatment, your weakened immune system can’t fight infection. Eventually you could develop AIDS.
Treating HIV during pregnancy
If your screening test is positive for HIV you will be referred to a specialist doctor who will advise on and oversee your treatment and follow up care.
They will prescribe antiretroviral drugs. Taking these won’t harm your unborn baby. This treatment helps protect your health and reduces the risk of your baby becoming infected.
After the birth, your baby will also require treatment with antiretroviral drugs and a blood test to see if they are infected with HIV.