Tuberculosis in pregnancy: a review.

Area of Science:

• Public Health
• Infectious Diseases
• Maternal Health

Background:

• Tuberculosis (TB) is a major global health concern, declared a public health emergency by the WHO in 2005.
• TB significantly contributes to maternal mortality and is a leading cause of death in women aged 15-45 in high-burden regions.
• The incidence of TB in pregnancy is presumed to be similar to the general population, yet diagnosis is often delayed due to overlapping symptoms with pregnancy.

Purpose of the Study:

• To highlight the challenges and complications of diagnosing and managing tuberculosis during pregnancy.
• To discuss the obstetric and perinatal implications of TB in pregnant women.
• To review current treatment strategies and preventive measures for TB in pregnancy, including Isoniazid preventive therapy and BCG vaccination.

Main Methods:

• Literature review and synthesis of existing data on tuberculosis in pregnancy.
• Analysis of diagnostic challenges and symptom overlap with pregnancy.
• Examination of obstetric complications and perinatal outcomes associated with maternal TB.

Main Results:

• Maternal TB can lead to spontaneous abortion, preterm labor, low birth weight, and increased neonatal mortality.
• Congenital TB, though rare, is associated with high perinatal mortality.
• First-line anti-TB drugs include Rifampicin, INH, and Ethambutol; Pyrazinamide use in pregnancy is increasing.

Conclusions:

• Effective TB control in pregnant women requires integrated strategies addressing living conditions, public awareness, HIV/AIDS prevention, and BCG vaccination.
• Isoniazid preventive therapy for HIV-positive pregnant women and INH prophylaxis for their infants are key WHO innovations.
• Prompt diagnosis and management of TB in pregnancy are essential to mitigate maternal and infant morbidity and mortality.