Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 13 , ISSUE 4 ( July-August, 2021 ) > List of Articles

Original Article

Fetomaternal Outcome of Pregnant Women Infected with Tuberculosis: An Analytical Study

Preeti F Lewis, Amita S Budhewar, Nitin Bhimrao Bavdekar

Keywords : Antenatal women, Maternal death, NICU admission, Perinatal outcome, Preterm birth, Stillbirth, Tuberculosis

Citation Information : Lewis PF, Budhewar AS, Bavdekar NB. Fetomaternal Outcome of Pregnant Women Infected with Tuberculosis: An Analytical Study. J South Asian Feder Obs Gynae 2021; 13 (4):197-201.

DOI: 10.5005/jp-journals-10006-1948

License: CC BY-NC 4.0

Published Online: 20-11-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Tuberculosis (TB) remains a major global public health problem, despite that maternal TB remains an obscure and underestimated issue. The prevalence of TB in pregnancy is not well known. The present study is aimed to determine the prevalence of TB and assess the obstetrical and perinatal outcomes of TB in antenatal women. Materials and methods: A prospective observational study was done in a tertiary care center over a period of 1 year from January 2019 to January 2020. Pregnant women in the age-group of 18–42 years diagnosed with TB in the antenatal period were included in our study for evaluating maternal and fetal outcomes. We excluded those antenatal women with a history of TB and adequately treated and cured and those women with TB who did not deliver during the study period. Data collected from individual case record included age, parity, socioeconomic status, time of diagnosis, and complication in antenatal, intrapartum, and postpartum period. The mean birth weight of infants and frequency of small for gestation, stillbirth, neonatal depression, neonatal intensive care unit (NICU) admission, and neonatal death were noted, and perinatal outcome was seen. Results: Five-thousand and two hundred patients delivered during the study period; among those, 70 diagnosed with TB in the antenatal period were included, making a prevalence rate of 1.34/1,000 per pregnant woman. There was a significant increase in the incidence of preterm delivery, anemia, and intrauterine growth restriction in TB. In our study, we found that maternal and perinatal outcomes in pregnant women with TB depend on site, the severity of disease, gestation at diagnosis, and complication of TB. Conclusion: The prevalence of TB in antenatal women at our institute was 1.34/1,000 per pregnant woman. A high suspicion is required to acknowledge the varying disease spectrum and thus complications of TB in antenatal women and initiate treatment early for better outcomes.


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  1. World Health Organization. WHO consolidated guidelines on tuberculosis: module 1: prevention: tuberculosis preventive treatment. In: WHO consolidated guidelines on tuberculosis: module 1: prevention: tuberculosis preventive treatment. World Health Organization; 2020.
  2. World Health Organization. Global tuberculosis report 2019. Geneva (Switzerland): World Health Organization; 2019.
  3. Baxi A, Neema H, Kadi P, et al. Prevalence of male genital tuberculosis in Indian infertile couples and its correlation with female genital tuberculosis. J South Asian Feder Obst Gynae 2016;8(1):13–15. DOI: 10.5005/jp-journals-10006-1377.
  4. Vijayageetha M, Kumar AM, Ramakrishnan J, et al. Tuberculosis screening among pregnant women attending a tertiary care hospital in Puducherry, South India: is it worth the effort? Global Health Action 2019;12(1):1564488. DOI: 10.1080/16549716.2018.1564488.
  5. Sugarman J, Colvin C, Moran AC, et al. Tuberculosis in pregnancy: an estimate of the global burden of disease. Lancet Glob Health 2014;2(12):e710–e716. DOI: 10.1016/S2214-109X(14)70330-4.
  6. Jonsson J, Kühlmann-Berenzon S, Berggren I, et al. Increased risk of active tuberculosis during pregnancy and postpartum: a register-based cohort study in Sweden. Eur Respir J 2020;55(3):1901886. DOI: 10.1183/13993003.01886-2019.
  7. Yadav V, Sharma JB, Kachhawa G, et al. Obstetrical and perinatal outcome in pregnant women with extrapulmonary tuberculosis. Indian J Tuberc 2019;66(1):158–162. DOI: 10.1016/j.ijtb.2018.10.010.
  8. Banu EA, Nechita A, Elkan-Cojocaru EM, et al. Risk of tuberculosis in low birth weight children from East Romania. Arch Med Sci 2020;16(1):162. DOI: 10.5114/aoms.2018.78768.
  9. Jana N, Vasishta K, Saha SC, et al. Obstetrical outcomes among women with extrapulmonary tuberculosis. New Engl J Med 1999;341(9): 645–649. DOI: 10.1056/NEJM199908263410903.
  10. Panchabhai TS, Patil PD, Shah DR, et al. An autopsy study of maternal mortality: a tertiary healthcare perspective. J Postgrad Med 2009;55(1):8. DOI: 10.4103/0022-3859.48434.
  11. Bates M, Ahmed Y, Kapata N, et al. Perspectives on tuberculosis in pregnancy. Int J Infect Dis 2015;32:124–127. DOI: 10.1016/j.ijid.2014.12.014.
  12. Chopra S, Siwatch S, Aggarwal N, et al. Pregnancy outcomes in women with tuberculosis: a 10-year experience from an Indian tertiary care hospital. Trop Doct 2017;47(2):104–109. DOI: 10.1177/0049475516665765.
  13. Muniyandi M, Ramachandran R. Socioeconomic inequalities of tuberculosis in India. Expert Opin Pharmacother 2008;9(10): 1623–1628. DOI: 10.1517/14656566.9.10.1623.
  14. Sobhy S, Babiker ZOE, Zamora J, et al. Maternal and perinatal mortality and morbidity associated with tuberculosis during pregnancy and the postpartum period: a systematic review and meta-analysis. BJOG 2017;124(5):727–733. DOI: 10.1111/1471-0528.14408.
  15. Gould JM, Aronoff SC. Tuberculosis and pregnancy-maternal, fetal, and neonatal considerations. Microbiol Spectr 2016;4(6):10.1128/microbiolspec.TNMI7-0016-2016. DOI: 10.1128/microbiolspec.TNMI7-0016-2016.
  16. Newton ER. Tuberculosis and pregnancy. Glob Libr Women's Med (ISSN: 1756-2228) 2008. DOI: 10.3843/GLOWM.10186.
  17. Gaifer Z. Epidemiology of extrapulmonary and disseminated tuberculosis in a tertiary care center in Oman. Int J Mycobacteriol 2017;6(2):162. DOI: 10.4103/ijmy.ijmy_31_17.
  18. Jana N, Barik S, Arora N, et al. Tuberculosis in pregnancy: the challenges for South Asian countries. J Obstet Gynaecol Res 2012;38(9):1125–1136. DOI: 10.1111/j.1447-0756.2012.01856.x.
  19. Nguyen HT, Pandolfini C, Chiodini P, et al. Tuberculosis care for pregnant women: a systematic review. BMC Infect Dis 2014;14(1):617. DOI: 10.1186/s12879-014-0617-x.
  20. Mahendru A, Gajjar K, Eddy J. Diagnosis and management of tuberculosis in pregnancy. Obstet Gynaecol 2010;12(3):163–171. DOI: 10.1576/toag.12.3.163.27598.
  21. Loto OM, Awowole I. Tuberculosis in pregnancy: a review. J Pregnancy 2012;2012. DOI: 10.1155/2012/379271.
  22. Sengupta M, Dasgupta A, Santra D, et al. Clinical manifestations and challenges in management of tuberculosis in pregnancy in a rural setting in Eastern India. J South Asian Feder Obst Gynae 2018;10(1):15–22. DOI: 10.5005/jp-journals-10006-1551.
  23. World Health Organization, Stop TB Initiative (World Health Organization). Treatment of tuberculosis: guidelines. World Health Organization; 2010.
  24. LaCourse SM, Greene SA, Dawson-Hahn EE, et al. Risk of adverse infant outcomes associated with maternal tuberculosis in a low burden setting: a population-based retrospective cohort study. Infect Dis Obstet Gynecol 2016;2016:6413713. DOI: 10.1155/2016/6413713.
  25. Figueroa-Damian R, Arredondo-Garcia JL. Pregnancy and tuberculosis: influence of treatment on perinatal outcome. Am J Perinatol 1998;15(5):303–306. DOI: 10.1055/s-2007-993948.
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