TB risk increases in early pregnancy

Women's health research has suggested postpartum women may need to be screened for tuberculosis (TB).


Researchers at the Health Protection Agency (HPA) and the University of East Anglia in the UK analysed data relating to 192,801 women with a total of 264,136 pregnancies from 460 practices across the UK between 1996 and 2008.


They found the TB rate for postpartum women was significantly higher than in the general population, but there did not appear to be any substantial difference in the likelihood of infection among pregnant females.


However, consultant in public health at the HPA's Respiratory Diseases Department Dominik Zenner said that there "is almost certainly" an increased risk for those carrying a child as well.


"Given our results, targeted screening of pregnant and postpartum women in high-risk groups may be warranted, given that delays in treatment initiation are associated with poorer outcomes for both mothers and their children," he stated.


In a joint study between scientists at the Health Protection Agency (HPA) and the University of East Anglia, researchers analysed data on all women with pregnancies between 1996 and 2008 from the General Practice Research Database.


A total of 192,801 women who had a total of 264,136 pregnancies were included in the study and over the 12 year period of study there were 177 TB cases among this group.


After adjusting for age, region and socio-economic status, post natal women had a significantly higher TB risk outside pregnancy, whereas no significant increase during pregnancy was observed. Overall the researchers calculated that the rate of TB among pregnant and post natal women was 15.4 per 100,000 people, which is significantly higher than the rate outside of pregnancy - 9.1 per 100,000.


Lead author Ibrahim Abubakar, head of TB surveillance at the HPA and Professor of infectious disease epidemiology at the University of East Anglia said: “This study clearly shows that future guidance to healthcare workers, especially midwives and health visitors, should take into account that the risk of TB may be increased during pregnancy or shortly after giving birth.


“Those looking after pregnant and post natal women should be encouraged to look out for the signs and symptoms of the disease, particularly among women in high risk groups such as immigrants from countries with a high burden of TB, as early diagnosis and appropriate treatment is essential. TB is a preventable and treatable condition but, if left untreated, can be life threatening.”