The Impact of Pregnancy on Tuberculosis Treatment Outcomes: An Analysis of Brazilian National Surveillance Data 2016-2022.
| Title: | The Impact of Pregnancy on Tuberculosis Treatment Outcomes: An Analysis of Brazilian National Surveillance Data 2016-2022. |
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| Authors: | Chiang SS; Department of Pediatics, Division of Pediatric Infectious Diseases, Alpert Medical School of Brown University, Providence, RI, USA.; Center for International Health Research, Rhode Island Hospital, Providence, RI, USA.; Campbell JR; Department of Medicine and Department of Global and Public Health, McGill University, Montreal, QC, Canada.; McGill International TB Centre, Montreal, QC, Canada.; Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.; Pelissari DM; Health and Environment Surveillance Secretariat, Ministry of Health, Brasilia, Brazil.; de Oliveira MCB; Department of Pediatrics, Souza Marques Medical School, Rio de Janeiro, Brazil.; Carvalho ACC; Laboratory of Innovation, Therapies, Teaching and Bioproducts, Oswaldo Cruz Institute (Fiocruz), Rio de Janeiro, Brazil.; LaCourse SM; Department of Medicine, Division of Allergy and Infectious Diseases, Department of Global Health; and Department of Epidemiology, University of Washington, Seattle, WA, USA.; Sant'Anna CC; Department of Pediatrics, Division of Pediatric Pulmonology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. |
| Source: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2026 Mar 17; Vol. 82 (3), pp. 513-521. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE |
| Imprint Name(s): | Publication: Jan. 2011- : Oxford : Oxford University Press; Original Publication: Chicago, IL : The University of Chicago Press, c1992- |
| MeSH Terms: | Antitubercular Agents*/therapeutic use ; Pregnancy Complications, Infectious*/drug therapy ; Pregnancy Complications, Infectious*/epidemiology ; Pregnancy Complications, Infectious*/mortality ; Tuberculosis*/drug therapy ; Tuberculosis*/epidemiology ; Tuberculosis*/mortality; Brazil/epidemiology ; Humans ; Female ; Pregnancy ; Adult ; Adolescent ; Young Adult ; Middle Aged ; Child ; Treatment Outcome ; Lost to Follow-Up |
| Abstract: | Background: More than 200 000 pregnant people fall ill with tuberculosis (TB) annually. Little is known about the impact of pregnancy on TB outcomes.; Methods: This study used surveillance data from Brazil's Ministry of Health. We included women aged 11-49 years newly diagnosed with drug-susceptible TB disease between 2016 and 2022, treated with a first-line anti-TB regimen, and with a known treatment outcome. Using multivariable regression, we estimated the age-stratified effect of pregnancy on (1) loss to follow-up and (2) death during TB treatment.; Results: Of 96 868 women with TB, 1870 (1.9%) were pregnant, 79 361 (81.9%) were not pregnant, and 15 637 (16.1%) had unknown pregnancy status. Among pregnant women, 1432 (76.6%) experienced treatment success, 358 (19.1%), lost to follow-up, and 80 (4.3%) died. Among nonpregnant women, 79 262 (83.4%) experienced treatment success, 11 582 (12.2%) were lost to follow-up, and 4154 (4.4%) died. In adolescents, pregnancy conferred higher odds of loss to follow-up (adjusted odds ratio [aOR], 1.78; 95% confidence interval [CI]: 1.29-2.44) and death (aOR, 2.35; 95% CI: 1.27-4.37). Compared to nonpregnant women of the same age, pregnant women aged 20-29 and 30-39 years experienced more loss to follow-up (respectively: aOR, 1.39; 95% CI: 1.17-1.66 and aOR 1.79; 95% CI, 1.42-2.25), while those aged 40-49 years were more likely to die (aOR, 1.66; 95% CI: 1.04-2.66).; Conclusions: Our analysis revealed a significant association between pregnancy and poor TB treatment outcomes, highlighting the need for care providers to offer enhanced support and monitoring for pregnant women undergoing TB treatment. Further research is needed to identify the underlying reasons for these findings.; (© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| Competing Interests: | Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. |
| Contributed Indexing: | Keywords: adolescent; loss to follow-up; maternal; mortality; prenatal |
| Substance Nomenclature: | 0 (Antitubercular Agents) |
| Entry Date(s): | Date Created: 20250506 Date Completed: 20260316 Latest Revision: 20260513 |
| Update Code: | 20260513 |
| DOI: | 10.1093/cid/ciaf233 |
| PMID: | 40327541 |
| Database: | MEDLINE |
Journal Article