<i>Notes from the Field: </i>Undiagnosed Tuberculosis During Pregnancy Resulting in a Neonatal Death — United States, 2021

In 2022, the World Health Organization reported 10.6 million new cases of tuberculosis (TB) globally.One third of these new cases were reported in women; however, pregnancy status was not included in these data.*CDC recently added pregnancy status to national TB reporting in the United States; however, because the number of U.S. TB cases during pregnancy is presumed to be low, adverse effects of TB on pregnancy and postpartum outcomes are likely not well characterized.† A 2017 meta-analysis of 13 studies that included approximately 123,000 pregnancies from several countries found that TB disease during pregnancy was associated with increased odds of maternal morbidity and mortality, including hospital admission, anemia of pregnancy, cesarean birth, miscarriage, preterm birth, low birthweight, and neonatal TB (1).TB diagnosis during pregnancy might be delayed because of overlap in symptoms of TB with those of pregnancy, as well as clinician reluctance to use chest radiography during pregnancy.§ Perinatal TB is a life-threatening illness, with a congenital and neonatal TB mortality rate of approximately 50% (2), highlighting the importance of diagnosing and treating TB before and during pregnancy.This report describes a case of fatal neonatal TB after successful in vitro fertilization in 2021.