Twenty-seven per cent of women received IPT during pregnancy, starting treatment at a median of 23 weeks of pregnancy. Pre-term births were somewhat less frequent in women who received IPT. The occurrence of the remaining adverse birth outcomes did not differ significantly according to IPT exposure and there was no difference in the risk of a composite adverse birth outcome any one of low birth weight, congenital abnormality, perinatal death or pre-term birth. An adverse birth outcome occurred in Dr Elizabeth Quincer said that ongoing data collection in diverse populations is needed to monitor the effects of IPT exposure in pregnant women with HIV.
Larger samples sizes are needed to assess any increased risk of rare birth outcomes including congenital abnormalities, she said.
Masuku S et al. Birth outcomes of pregnant women exposed to isoniazid preventive therapy. Skip directly to site content Skip directly to page options Skip directly to A-Z link.
Tuberculosis TB. Section Navigation. Facebook Twitter LinkedIn Syndicate. Infants born to women with untreated TB may be of lower birth weight than those born to women without TB and, in rare circumstances, the infant may be born with TB. 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.
Treatment for Latent TB Infection and Pregnancy For most pregnant women, treatment for latent TB infection can be delayed until 2—3 months post-partum to avoid administering unnecessary medication during pregnancy. Pyridoxine vitamin B6 should be added to the drug treatment of tuberculosis in all pregnant women taking isoniazid. Tuberculin testing is safe, but BCG vaccination should be avoided in pregnancy and instead given earlier in life.
Abstract Untreated tuberculosis in pregnancy poses a significant threat to the mother, fetus and family. Persons living with HIV are at high risk for tuberculosis TB reactivation and disease — and TB during pregnancy is associated with adverse maternal and infant outcomes. Based on data in nonpregnant adults, WHO guidelines recommend isoniazid preventive therapy in pregnant women with HIV.
In this placebo-controlled, randomized noninferiority trial involving pregnant women 14 through 34 weeks' gestation with HIV infection, researchers compared the outcomes of isoniazid preventive therapy mg daily for 28 weeks initiated during pregnancy immediate group or at 12 weeks postpartum deferred group.
The primary outcome a composite of maternal adverse events or treatment discontinuation due to toxicity occurred in 72 women in the immediate group Two women in the immediate group and four in the deferred group died.
TB developed in six women three in each group. Although this study excluded women in the first trimester and those with recent TB exposure, the results demonstrate that in countries with high TB prevalence, it's safe to defer isoniazid preventive therapy until 12 weeks after delivery in pregnant women with HIV who are receiving ART.
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