Tuberculosis skin testing in pregnancy: trends in a population

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Obstetrics

Background:

• Tuberculosis (TB) epidemiology is shifting in the U.S. due to factors like HIV, homelessness, and immigration.
• Pregnant women in New Orleans present with several TB risk factors.
• This study compares current TB risk in pregnant women to a 1983 report.

Purpose of the Study:

• To identify the primary risk factors for tuberculosis in pregnant women in New Orleans.
• To compare current TB prevalence with historical data.

Main Methods:

• Tuberculosis skin testing was offered to 1621 pregnant women seeking obstetric care between January 1994 and April 1995.
• Positive skin test defined as ≥10 mm induration (≥5 mm for HIV-positive patients) at 48 hours.
• Data on HIV status and ethnicity were collected and compared to 1981-1982 data.

Main Results:

• Hispanic ethnicity was the only significant risk factor for a positive TB skin test in 1994.
• Hispanics, the most recent immigrant group, showed the highest risk.
• Human immunodeficiency virus (HIV) status was not a significant predictor of TB skin test conversion.

Conclusions:

• Recent immigrants to the U.S. represent the highest risk group for tuberculosis among pregnant women in this urban setting.
• Findings align with national data from the Centers for Disease Control and Prevention (CDC).
• Routine TB skin testing should be integrated into obstetric care for recently immigrated pregnant women.