If left untreated, the hepatitis A virus (HAV) can increase your risk for certain pregnancy complications.

During pregnancy, your body allocates its resources to the growth of a new human being. You share with your baby much of what you do and experience. Sometimes illnesses that don’t significantly affect you can affect your baby.

Hepatitis A virus (HAV) is self-limiting for most adults, meaning it clears up on its own, typically without treatment. Some people may not even experience the symptoms.

Contracting hepatitis A during pregnancy is a different — often more serious — situation. Hepatitis A symptoms can fly under your radar, and can potentially increase the risks for complications like preterm birth.

Hepatitis is an inflammation of the liver. It’s a condition with many underlying causes, including viral infection. When a virus is the cause, your doctor diagnoses you with viral hepatitis.

One of the five liver-specific viruses, A, B, C, D, or E, causes viral hepatitis. All of these viruses cause infection in the liver leading to inflammation, but due to their unique disease patterns, they are of five specific subtypes.

Other variants of viral hepatitis likely exist. When the infection is unlike any one of the five well-known hepatitis viruses, your doctor may refer to it as “hepatitis X.”

Hepatitis A is an acute or short-term form of viral hepatitis. It passes from one person to another through contact with feces containing the virus.

Many people are exposed to the virus through food or water carrying particles of stool, but you can also contract HAV through the fecal-oral route, which may occur during rimming or analingus.

Symptoms tend to develop 2–7 weeks after exposure. While most people don’t need treatment and recover in a few weeks, HAV may survive in your body for up to 6 months and may lead to liver failure in rare cases.

Symptoms include:

  • fatigue
  • nausea/vomiting
  • abdominal pain
  • jaundice
  • joint pain
  • appetite loss
  • dark yellow urine
  • diarrhea
  • clay-colored stool

Hepatitis A can cause changes in your body that increase your risk for certain pregnancy complications, particularly early delivery.

According to a 2020 review on viral hepatitis in pregnancy, preterm labor occurs in more than 60% of cases and is more likely if you’ve gotten the virus in a later trimester.

Other possible pregnancy complications from HAV infection include:

In rare cases, your baby can contract HAV infection through vertical transmission (transmitted during pregnancy).

In addition to possible damage to your baby’s liver, HAV transmitted during pregnancy can result in neonatal meconium peritonitis, a rupture of your baby’s bowel that causes inflammation of the abdominal lining.

Although pregnancy complications from HAV can be serious, not everyone who contracts hepatitis A during pregnancy will experience these challenges.

Which type of hepatitis affects pregnancy the most?

Hepatitis A and hepatitis E are short-term forms of viral hepatitis that most adults experience without complications. In pregnancy, they’re the two most concerning types of viral hepatitis.

Hepatitis E shares many of the same potential pregnancy complications as hepatitis A, but other complications that hepatitis E may cause include:

Breastfeeding is not associated with transmission of HAV to the baby. If you’re experiencing an HAV infection while breastfeeding, you can continue to nurse as you have been with no contraindications.

It’s natural for antibodies from HAV infection to be detected in your breast milk if you’ve developed hepatitis A during pregnancy. It shouldn’t be a reason to stop nursing, as doctors would encourage you to breastfeed your baby.

Your doctor may make an individualized recommendation based on the severity or progression of your acute HAV infection.

There’s no specific treatment for hepatitis A. Due to the low risk of transmission during pregnancy, initial treatment focuses on the health of the pregnant person.

Your doctor will discuss a recovery plan with you that includes plenty of rest, adequate nutrition, and proper hydration. Hospitalization is usually only necessary if you develop liver complications.

Prescriptions can help manage symptoms of fever or vomiting, and use over-the-counter (OTC) products only under the guidance of your doctor. Some OTC products, including supplements and vitamins, may cause damage to your liver when taken during HAV infection.

The World Health Organization recommends not using any unnecessary medications during HAV recovery and suggests avoiding acetaminophen and paracetamol, common OTC pain relievers.

If you’re pregnant and concerned about recent contact with HAV, your doctor may give you an injection of hepatitis A immunoglobulin — short-acting antibodies that can help fight or prevent infection.

Hepatitis A immunoglobulin may also be administered to your baby within 48 hours of birth if you develop hepatitis A during your third trimester.

Is hepatitis A vaccine recommended in pregnancy?

The hepatitis A vaccine is safe for use during pregnancy and follows the same immunization schedule used for people who aren’t pregnant.

Doctors recommend hepatitis A vaccine for pregnant people with a high risk for HAV-related pregnancy complications.

People receive vaccines in 2- or 3-dose series, depending on the product used. After your first dose, boosters are done in multi-week or monthly intervals, as directed by your doctor and the vaccine manufacturer.

Hepatitis A is a type of liver inflammation caused by HAV. While it’s usually mild and self-limiting in healthy adults, hepatitis A can pose serious health concerns in pregnant people.

Hepatitis A in pregnancy may lead to preterm birth, leakage of amniotic fluid, and premature separation of the placenta, among other concerns.

While there’s no specific treatment for hepatitis A, it’s safe to be vaccinated for this virus while pregnant. If you suspect you have an HAV infection, proactive treatment with immunoglobulin may prevent the newborn from getting the infection.