The relation of child-bearing and child-rearing to pulmonary tuberculosis

Abstract

Summary 1. The relation of child-bearing and child-rearing to pulmonary tuberculosis is discussed. 2. The need for early diagnosis of unsuspected tuberculosis in pregnant women is stressed, and the desirability for a radiological examination of the chest as an integral part of antenatal supervision is advocated. 3. Active tuberculous lesions should be treated as if no pregnancy existed, and inactive cases should be regularly and carefully observed and supervised. Active cases may be allowed to become pregnant if the disease is controlled by therapy, or if the parents wish to risk all for a living child. The psychological reaction of the mother is of paramount importance. In active cases of known tuberculosis the practice of contraception is advised when no religious scruples preclude. 4. The second stage of labour should be diminished in time, and the puerperium should be prolonged. Lactation should be forbidden. 5. The child should not be nursed or fed by a mother who has active disease, and should be given B.C.G. within the first week after birth whether the disease of the mother is active or inactive. Chemotherapy given for the maternal lesion does not affect the child. 6. No special adverse influence upon the course of tuberculosis is attributable to child-bearing, but child-rearing may give rise to deterioration of the maternal disease. Retrogression, when it occurs, is often due to other factors which would cause a breakdown even if no pregnancy existed. 7. Within the broad limits of generalisation, each individual case must be assessed on its merits, including physiological, psychological and pathological, as well as social and economic factors.