Tuberculosis Infection in Pregnant People: Current Practices and Research Priorities

Overview

Journal Pathogens

Date 2022 Dec 23

PMID 36558815

Authors

Jyoti S Mathad

Sharan Yadav

Arthi Vaidyanathan

Amita Gupta

Sylvia M LaCourse

Affiliations

Soon will be listed here.

Abstract

Women are significantly more likely to develop tuberculosis (TB) disease within the first 90 days after pregnancy than any other time in their lives. Whether pregnancy increases risk of progression from TB infection (TBI) to TB disease is unknown and is an active area of investigation. In this review, we discuss the epidemiology of TB and TBI in pregnancy, TBI diagnostics, and prevalence in pregnancy. We also review TBI treatment and highlight research priorities, such as short-course TB prevention regimens, drug-resistant TB prevention, and additional considerations for safety, tolerability, and pharmacokinetics that are unique to pregnant and postpartum people.

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References

Kang Y, Lee H, Yoon H, Cho B, Han S, Shim Y . Discrepancy between the tuberculin skin test and the whole-blood interferon gamma assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country. JAMA. 2005; 293(22):2756-61. DOI: 10.1001/jama.293.22.2756. View

Miele K, Morris S, Tepper N . Tuberculosis in Pregnancy. Obstet Gynecol. 2020; 135(6):1444-1453. PMC: 7975823. DOI: 10.1097/AOG.0000000000003890. View

Mulligan N, Best B, Wang J, Capparelli E, Stek A, Barr E . Dolutegravir pharmacokinetics in pregnant and postpartum women living with HIV. AIDS. 2018; 32(6):729-737. PMC: 5854536. DOI: 10.1097/QAD.0000000000001755. View

Schulte J, Bryan P, Dodds S, Potter M, Onorato I, OSullivan M . Tuberculosis skin testing among HIV-infected pregnant women in Miami, 1995 to 1996. J Perinatol. 2002; 22(2):159-62. DOI: 10.1038/sj.jp.7210617. View

Walles J, Tesfaye F, Jansson M, Balcha T, Sturegard E, Kefeni M . Tuberculosis Infection in Women of Reproductive Age: A Cross-sectional Study at Antenatal Care Clinics in an Ethiopian City. Clin Infect Dis. 2020; 73(2):203-210. PMC: 8282312. DOI: 10.1093/cid/ciaa561. View

Froberg G, Jansson L, Nyberg K, Obasi B, Westling K, Berggren I . Screening and treatment of tuberculosis among pregnant women in Stockholm, Sweden, 2016-2017. Eur Respir J. 2020; 55(3). DOI: 10.1183/13993003.00851-2019. View

Nahid P, Dorman S, Alipanah N, Barry P, Brozek J, Cattamanchi A . Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. Clin Infect Dis. 2016; 63(7):e147-e195. PMC: 6590850. DOI: 10.1093/cid/ciw376. View

Zenner D, Kruijshaar M, Andrews N, Abubakar I . Risk of tuberculosis in pregnancy: a national, primary care-based cohort and self-controlled case series study. Am J Respir Crit Care Med. 2011; 185(7):779-84. DOI: 10.1164/rccm.201106-1083OC. View

Worjoloh A, Kato-Maeda M, Osmond D, Freyre R, Aziz N, Cohan D . Interferon gamma release assay compared with the tuberculin skin test for latent tuberculosis detection in pregnancy. Obstet Gynecol. 2011; 118(6):1363-1370. PMC: 3232049. DOI: 10.1097/AOG.0b013e31823834a9. View

10.

Kaplan S, Escudero J, Mecha J, Richardson B, Maleche-Obimbo E, Matemo D . Interferon Gamma Release Assay and Tuberculin Skin Test Performance in Pregnant Women Living With and Without HIV. J Acquir Immune Defic Syndr. 2021; 89(1):98-107. PMC: 8665065. DOI: 10.1097/QAI.0000000000002827. View

11.

Kalk E, Heekes A, Mehta U, de Waal R, Jacob N, Cohen K . Safety and Effectiveness of Isoniazid Preventive Therapy in Pregnant Women Living with Human Immunodeficiency Virus on Antiretroviral Therapy: An Observational Study Using Linked Population Data. Clin Infect Dis. 2020; 71(8):e351-e358. PMC: 7643738. DOI: 10.1093/cid/ciz1224. View

12.

Moulding T, Redeker A, Kanel G . Twenty isoniazid-associated deaths in one state. Am Rev Respir Dis. 1989; 140(3):700-5. DOI: 10.1164/ajrccm/140.3.700. View

13.

Mathad J, Gupta A . Tuberculosis in pregnant and postpartum women: epidemiology, management, and research gaps. Clin Infect Dis. 2012; 55(11):1532-49. PMC: 3491857. DOI: 10.1093/cid/cis732. View

14.

Molina R, Venkatesh K, Schantz-Dunn J, Meadows A, Nour N, Diouf K . Comparing an Interferon Gamma Release Assay with the Tuberculin Skin Test During Pregnancy: Implications for Tuberculosis Screening During Prenatal Care. Matern Child Health J. 2015; 20(6):1314-20. DOI: 10.1007/s10995-015-1896-6. View

15.

Shah N, Yuen C, Heo M, Tolman A, Becerra M . Yield of contact investigations in households of patients with drug-resistant tuberculosis: systematic review and meta-analysis. Clin Infect Dis. 2013; 58(3):381-91. PMC: 3890332. DOI: 10.1093/cid/cit643. View

16.

Sheriff F, Manji K, Manji M, Chagani M, Mpembeni R, Jusabani A . Latent tuberculosis among pregnant mothers in a resource poor setting in Northern Tanzania: a cross-sectional study. BMC Infect Dis. 2010; 10:52. PMC: 2846946. DOI: 10.1186/1471-2334-10-52. View

17.

Lee J, Choi H, Park I, Hong S, Oh Y, Lim C . Comparison of two commercial interferon-gamma assays for diagnosing Mycobacterium tuberculosis infection. Eur Respir J. 2006; 28(1):24-30. DOI: 10.1183/09031936.06.00016906. View

18.

Tiam A, Machekano R, Gounder C, Maama-Maime L, Ntene-Sealiete K, Sahu M . Preventing tuberculosis among HIV-infected pregnant women in Lesotho: the case for rolling out active case finding and isoniazid preventive therapy. J Acquir Immune Defic Syndr. 2014; 67(1):e5-e11. DOI: 10.1097/QAI.0000000000000209. View

19.

. Targeted tuberculin testing and treatment of latent tuberculosis infection. American Thoracic Society. MMWR Recomm Rep. 2000; 49(RR-6):1-51. View

20.

Mathad J, Bhosale R, Sangar V, Mave V, Gupte N, Kanade S . Pregnancy differentially impacts performance of latent tuberculosis diagnostics in a high-burden setting. PLoS One. 2014; 9(3):e92308. PMC: 3962385. DOI: 10.1371/journal.pone.0092308. View