Tuberculosis and Pregnancy: An Updated Systematic Review

Alice Claudia Repossi* and Graham H. Bothamley

Tuberculosis and Pregnancy: An Updated Systematic Review.

Tuberculosis affects women, especially in the child-bearing years. TB is associated with a poorer outcome of pregnancy, although this may be due to the general risk factors for TB, namely poverty, malnutrition and overcrowding.

New studies have shown that symptom screening has a low sensitivity and specificity, but is improved by the addition of a tuberculin skin test or interferon-gamma release assay or, in high incidence areas, DNA amplification tests. TB-HIV co-infection is a common cause of mortality and morbidity in pregnancy.

The diagnostic process remains the same in pregnancy, but non-specific symptoms and extra pulmonary disease demand a higher level of suspicion of TB. Standard first-line treatment is safe in pregnancy.

Data on second-line drugs in pregnancy is still limited, but injectable drugs may affect the hearing and balance of the fetus. The IGRA responses appear to change during pregnancy, with more positive responses after delivery.

The increasing incidence of drug-resistant TB, especially in Eastern Europe and Central Asia,
requires an evaluation of the safety of second-line drugs in pregnancy. Tuberculosis remains an important disease, despite effective treatment for the last 50 years. The number of cases remains high at 8.6 million new cases and 1.3 million TB deaths.

Although TB affects men more commonly than women, there were still 2.9 million cases
and 410,000 deaths among women, predominantly in the 15-44 year age
group, which coincides with the age of childbearing.

Pulm Res Respir Med Open J. 2015; 2(1): 63-68. doi: 10.17140/PRRMOJ-2-109