Abtract Objectives-To launch a programme for the prevention of perinatal infection with hepatitis B in the Netherlands.

Design-Routine antenatal screening and intervention programme.

Setting-Community antenatal programme, the Netherlands.

Subjects-Infants of mothers who were carriers of hepatitis B detected by routine screening.

Interventions-Infants of infected mothers received hepatitis B immunoglobulin at birth and four doses of hepatitis B vaccine in conjunction with routine immunisation at 3,4,5, and 11 months of age.

Main outcome measures-Results of screening and immunisation from 1989-92.

Results

The coverage of screening increased from 46% in 1989 to 84% in 1992.

Hepatitis B surface antigen was detected in 2145 women (0.44%). There was considerable variation in the timing of vaccination ; 17% (258) of the infants received their first dose more than two weeks late.

Of the 59% (583) of infants who received the fourth dose more than two weeks beyond target age, 14% (141) also received their first dose too late.

Conclusions-A prevention programme for perinatal hepatitis B in an area of low prevalence, when incorporated into existing health care, is feasible and achieves satisfactory coverage rates.

Intensive follow up is needed to improve adherence to the immunisation schedule.