Risk of Adverse Infant Outcomes Associated with Maternal Tuberculosis in a Low Burden Setting: A Population-Based Retrospective Cohort Study

Abstract

Background. Maternal tuberculosis (TB) may be associated with increased risk of adverse infant outcomes. Study Design. We examined the risk of low birth weight (LBW), small for gestational age (SGA), and preterm birth (<37 weeks) associated with maternal TB in a retrospective population-based Washington State cohort using linked infant birth certificate and maternal delivery hospitalization discharge records. We identified 134 women with births between 1987 and 2012 with TB-associated ICD-9 diagnosis codes at hospital delivery discharge and 536 randomly selected women without TB, frequency matched 4 : 1 on delivery year. Multinomial logistic regression analyses were performed to compare the risk of LBW, SGA, and preterm birth between infants born to mothers with and without TB. Results. Infants born to women with TB were 3.74 (aRR 95% CI 1.40–10.00) times as likely to be LBW and 1.96 (aRR 95% CI 0.91–4.22) as likely to be SGA compared to infants born to mothers without TB. Risk of prematurity was similar (aRR 1.01 95% CI 0.39–2.58). Conclusion. Maternal TB is associated with poor infant outcomes even in a low burden setting. A better understanding of the adverse infant outcomes associated with maternal TB, reflecting recent trends in US TB epidemiology, may inform potential targeted interventions in other low prevalence settings.

Performance of QuantiFERON-TB Gold Plus for detection of latent tuberculosis infection in pregnant women living in a tuberculosis- and HIV-endemic setting

“…It has also been suggested that pregnancy may confer an increased risk of LTBI reactivation [ 5 , 6 ]. Furthermore, since active TB is associated with adverse pregnancy outcomes [ 7 – 9 ], TB screening is recommended during antenatal care.…”

A woman with disseminated tuberculosis experienced preterm delivery, fallopian tube pregnancy, and delivered successfully following in vitro fertilization: a case report

“…Besides, the possibility of postnatal transmission may exist when the infant’s mother wasn’t isolated immediately with the infant after delivery. According to Sylvia [ 11 ] et al population-based retrospective cohort study, infants born to mothers with maternal TB had similar chance of preterm delivery compared to those born to mothers without TB. After adjusting women’s conditions to the same, the chance of preterm delivery was decreased but remained similar between infants born to mothers with and without TB, indicating that there is no association with prematurity.…”

240. Stellungnahme des DZK in Zusammenarbeit mit FZB, DGI, DGPI, GPP, DGGG, DRG und DGMP zum Tuberkulosescreening bei Schwangeren im Kontext von § 36 (4) Infektionsschutzgesetz (IfSG)

“…Schwangere haben ein erhöhtes Risiko, an Tuberkulose zu erkranken, insbesondere, wenn eine HIV-Koinfektion besteht. Kinder von Frauen, die während der Schwangerschaft an Tuberkulose erkranken, zeigen häufiger ein niedrigeres Geburtsgewicht und sind häufiger zu klein bezogen auf das Gestationsalter im Vergleich zu Kindern von gesunden Müttern [1][2][3].…”

“…Epidemiologische Daten aus den USA zeigen, dass die TB-Inzidenz in den ersten 180 Tagen post partum auch in TB-Niedriginzidenzländern erhöht ist, möglicherweise auch bereits schon während der Schwangerschaft [2].…”