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Diagnosis of tuberculosis is increased in postpartum women
Date:12/8/2011

s, which was significantly higher than the rate outside of pregnancy (9.1 per 100,000 person years, p=0.02). After adjustment for age, region and socio-economic status, post-partum TB risk was significantly higher than TB risk outside pregnancy (IRR 1.95, CI 1.24-3.07), whereas no significant increase during pregnancy was observed (IRR 1.29, CI 0.82-2.03).

These observations were confirmed in the SCCS analysis. Adjusting for all non-time bound confounders, the time period of observation and patients' age, the IRR of TB during pregnancy (1.03, CI 0.64-1.65) was not significantly increased compared with the risk outside of pregnancy. However, the TB risk was significantly increased in the 6 month period following pregnancy (IRR 1.61, CI 1.01-2.58, p=0.04).

The study had a few limitations, including its observational design. Administrative delay between TB diagnosis and recording of the diagnosis may have occurred. Diagnostic delays may also occur during pregnancy. Immunological changes during pregnancy gradually increase TB susceptibility and then gradually normalize after delivery. The combination of these factors may account for the failure to show a significantly increased TB risk during pregnancy in this study.

"The incidence of TB diagnosis is significantly increased post-partum, probably reflecting an increase in TB incidence during pregnancy," concluded Dr. Zenner. "Given our results, targeted screening of pregnant and post-partum 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."


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Contact: Nathaniel Dunford
ndunford@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

Page: 1 2

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