The maternal and fetal effects of tuberculosis therapy

Tuberculosis can cause significant morbidity in the pregnant woman, fetus, and members of the community. The first-line agents suggested by the CDC for use during pregnancy (isoniazid, rifampin, and ethambutol) seem to have minimal risk of induced congenital anomalies. Maternal morbidity associated with therapy does not seem increased above rates observed in the nonpregnant population. Education of the patient concerning the potential adverse side effects may decrease maternal morbidity. Therapy should be started as soon as the diagnosis of tuberculosis is confirmed (or when suspected in the HIV-infected woman) or after the first trimester in women younger than 35-years-old with recent TB tine test conversion. Monitoring for medication compliance during pregnancy is important to provide effective therapy and to decrease the development of resistant organisms.