Background Hepatitis B virus (HBV) infection is a major global health problem. In Chad, the prevalence is estimated at 19% in the overall population. Control hepatitis B among pregnant women may help to break the chain of transmission. However, the prevalence and risk factors of hepatitis B among pregnant women in N'Djamena are not documented. The aim of this study was to establish the HBV prevalence and identify the risk factors associated with hepatitis B in pregnant women in N'Djamena. Methods We conducted a cross-sectional study in eight health facilities in the city of N'Djamena (Chad) from April 4 to August 2, 2021. HBV surface antigen was determined using the SD Bioline HBsAg WB rapid test. We performed a Chi-squared test and an adjusted logistic regression to identify risk factors associated with hepatitis B infection. Results A total of 458 pregnant women were included in the study. The average age of participants was 25 years (95% CI: 20–30). Among risk factors, being older (age > 35 years) and having been tested for HBsAg increase the likelihood of being HBsAg+ (OR = 1.22, 95% CI: 0.33–3.92, p = 0.001, and OR = 4.93, 95% CI: 2.05-12.0, p < 0.001).). Pregnant women whose mothers were AgHBs + were also more likely to be HBsAg+ (OR = 27.8; 95% CI: 4.17–192; P = 0.004). Conclusion The prevalence of hepatitis B shows intermediate endemicity in pregnant women in Chad. Age, HBsAg carrier mother, and history of HBsAg screening are associated with HBV infection.). Thus, to avoid mother to child transmission of HBV, here is a need to improve the health education of pregnant women and the access to routine prenatal screening and vaccination of newborns at birth. It is also important to increase the immunization coverage of the population, through children vaccination campaigns.

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