Perinatal Outcome and Long-Term Infectious Morbidity of Offspring Born to Women with Known Tuberculosis.

Shanny Sade,Eyal Sheiner,Tamar Wainstock,Gali Pariente

doi:10.3390/jcm9092768

Shanny Sade, Eyal Sheiner + Show 2 more

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https://doi.org/10.3390/jcm9092768

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Abstract

Objective: To evaluate the perinatal outcome of women with tuberculosis and to assess a possible association between maternal tuberculosis and long-term infectious morbidity of the offspring. Study design: Perinatal outcome and long-term infectious morbidity of offspring of mothers with and without tuberculosis were assessed. The study groups were followed until 18 years of age tracking infectious-related morbidity and infectious-related hospitalizations and then compared. For perinatal outcome, generalized estimation equation models were used. A Kaplan-Meier survival curve was used to compare cumulative incidence of long-term infectious morbidity. A Cox proportional hazards model was conducted to control for confounders. Results: During the study period, 243,682 deliveries were included, of which 46 (0.018%) occurred in women with tuberculosis. Maternal tuberculosis was found to be independently associated with placental abruption, cesarean deliveries, and very low birth weight. However, offspring born to mothers with tuberculosis did not demonstrate higher rates of infectious-related morbidity. Maternal tuberculosis was not noted as an independent risk factor for long-term infectious morbidity of the offspring. Conclusion: In our study, maternal tuberculosis was found to be independently associated with adverse perinatal outcomes. However, higher risk for long-term infectious morbidity of the offspring was not demonstrated. Careful surveillance of these women is required.

Highlights

Tuberculosis is a contagious disease caused by Mycobacterium tuberculosis and is the second most common infectious cause of death in adults worldwide [1]
Immunosuppressed individuals are at risk of developing active tuberculosis once infected, patients with Acquired Immuno-Deficiency Syndrome (AIDS) [1]
No difference in rate of long-term infectious morbidity of the offspring was demonstrated between active and latent tuberculosis during pregnancy. In this large population-based cohort study, we found that placental abruption, cesarean delivery and very low birth weight neonates were all more frequent in mothers with tuberculosis compared to mothers without tuberculosis

Summary

Introduction

Tuberculosis is a contagious disease caused by Mycobacterium tuberculosis and is the second most common infectious cause of death in adults worldwide [1]. The disease appeared hundreds of years ago and remained sporadic until the Industrial Revolution in the 18th century, when it became endemic, owing to the increased population density and unfavorable living conditions [1]. About one third of the world’s population is infected with tuberculosis, 75% of whom are 15–54 years old [2]. Immunosuppressed individuals are at risk of developing active tuberculosis once infected, patients with Acquired Immuno-Deficiency Syndrome (AIDS) [1]. Despite a rigorous global effort over the past two decades to reduce the burden of tuberculosis by developing new drugs, diagnostics, and vaccines, it remains a global emergency. Tuberculosis is responsible for the deaths of more than 1 million people every year, most of them in low-income countries, with the majority of cases occurring in Asia (58%) and Africa (28%) [3,4,5]

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