A doctor will give several routine tests to pregnant woman to check for any health issues that might affect the health of the child & the mother. One of them is an examination for tuberculosis (TB), which is an infectious bacterial disease that usually attacks the lungs. It can be dangerous for the baby & the mother if they do not get the right treatment for TB.
Latent TB vs Active TB. Which is more dangerous for babies?
Pregnant woman can have TB and not know it, that is called latent TB. But if the pregnant woman has active TB, then there's a symptoms like coughing for weeks, weight loss, bloody phlegm, and night sweats. The active form of the disease is more serious. But both active and latent TB can cause harm to the baby. They may be more likely to:
- Weigh less than a baby born to a healthy mother
- Be born with TB (rare case)
- Catch TB from mother after birth (if the disease is active and the mother are not being treated)
A pregnant woman who is diagnosed with TB may worry that the medicine will harm her unborn baby. However, it will get worse if TB is just left and not treated. The drugs that will be prescribed to pregnant woman will depend on the type of TB they have. Although the drugs used in the initial treatment regimen for TB cross the placenta, they do not appear to have harmful effects on the fetus.
TB Treatment During Pregnancy
Picture 1. Illustration
- Latent TB
If there are no symptoms but tests show that the pregnant woman have the disease, doctor likely prescribed a drug called isoniazid. Isoniazid needs to take it every day for 9 months, or just twice a week during that time. Then, take vitamin B6 supplements at the same time or also take a combination of isoniazid and rifampin for 3 months.
- Active TB
Usually, doctor will prescribe three drugs at first: isoniazid, rifampin, and ethambutol and it need to take all three every day for 2 months. For the rest of pregnancy time, the pregnant woman just takes only isoniazid and rifampin, either daily or twice a week.
- HIV and TB
Treatment of TB disease for pregnant women co-infected with HIV should be the same as for nonpregnant women, but with attention given to additional considerations. Talk to the doctor to understand the safest options for the baby and the mother.
- Complications
If the first drugs do not work against the TB, the pregnant woman may have a drug-resistant form of the disease. Doctor may recommend to switch to so-called second-line drugs. Some of them are not safe to take during pregnancy because they can cause birth defects and other problems. If the pregnant woman needs second-line treatment, they may need to avoid or delay getting pregnant. Ask the doctor for counseling.
- Breastfeeding
Breastfeeding should not be discouraged for women being treated with the first-line antituberculosis drugs, because the concentrations of these drugs in breast milk are too small to produce toxicity in the nursing newborn.
Early diagnosis and treatment of TB in pregnancy can reduce maternal and neonatal morbidities and mortality. Prompt treatment with first-line medications also has been proven to be safe in pregnancy and prevents significant maternal and perinatal complications.
References:
- CDC. (2020). Treatment for TB During Pregnancy
- National Library of Medicine. (2022). Tuberculosis in pregnancy
- WebMD. (2022). Tuberculosis Treatment During Pregnancy
