Tuberculosis in Pregnancy: An Updated Narrative Review

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Public Health

Background:

• Tuberculosis (TB) is a major global health threat, disproportionately impacting women of reproductive age.
• Pregnancy complicates TB diagnosis and management due to physiological changes, potentially leading to adverse maternal and perinatal outcomes.

Purpose of the Study:

• To provide an updated, clinically focused review of tuberculosis in pregnancy.
• To emphasize diagnostic challenges, imaging, microbiological testing, complications, and therapeutic management.

Main Methods:

• Narrative review of current evidence and international recommendations.
• Discussion of diagnostic tools including symptom screening, TST, IGRA, GeneXpert MTB/RIF, MTB/RIF Ultra, and imaging (CXR, CT).

Main Results:

• Pregnancy can mask TB symptoms, delaying diagnosis and increasing risks.
• TB impacts pregnancy outcomes (prematurity, low birth weight) and neonatal health.
• HIV coinfection and multidrug-resistant TB present unique management challenges.

Conclusions:

• Effective diagnostic algorithms and management strategies are crucial for improving maternal and neonatal outcomes.
• Addressing evidence gaps and prioritizing research are essential for TB care in pregnant populations.
• Current evidence and recommendations guide treatment, prevention, and neonatal care.