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Obstetrical outcomes among women with extrapulmonary tuberculosis
1Department of Obstetrics and Gynaecology, Memorial Hospital, Darlington, United Kingdom.
The New England Journal of Medicine
|August 26, 1999
Summary
Extrapulmonary tuberculosis confined to lymph nodes does not impact pregnancy outcomes. However, tuberculosis affecting other sites during pregnancy is linked to increased antenatal complications and adverse infant outcomes.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Perinatology
Background:
- Increasing global prevalence of tuberculosis, particularly extrapulmonary forms.
- Limited data exists on pregnancy outcomes for women with extrapulmonary tuberculosis.
- This study investigates pregnancy, labor, and infant outcomes in this population.
Purpose of the Study:
- To evaluate the impact of extrapulmonary tuberculosis on pregnancy course and delivery.
- To compare perinatal outcomes in mothers with extrapulmonary tuberculosis versus healthy controls.
- To differentiate outcomes based on the site of extrapulmonary tuberculosis.
Main Methods:
- Prospective follow-up of 33 pregnant women with extrapulmonary tuberculosis (1983-1993).
- Comparison with 132 matched healthy pregnant women.
- Antenatal complications, intrapartum events, and perinatal outcomes were analyzed.
Main Results:
- Tuberculous lymphadenitis showed no adverse effect on pregnancy or perinatal outcomes.
- Women with tuberculosis at other extrapulmonary sites had higher antenatal hospitalization rates (24% vs 2%).
- These women also had increased rates of low Apgar scores (19% vs 3%) and low-birth-weight infants (33% vs 11%).
Conclusions:
- Extrapulmonary tuberculosis limited to lymph nodes does not negatively affect obstetrical outcomes.
- Tuberculosis involving other extrapulmonary sites adversely impacts pregnancy outcomes.
- Early diagnosis and management are crucial for pregnant women with extrapulmonary tuberculosis.