Pregnancy among people with TB disease

SUMMARY BACKGROUND Globally, TB disproportionately impacts people of childbearing age. However, the impact of pregnancy among people with TB in California is unknown. METHODS Women aged 15–49 years with TB in California during 1993–2019 were matched to California birth records to identify those whose pregnancies or postpartum periods overlapped with TB treatment. Demographic and clinical variables were compared by pregnancy status, which included ‘peri-pregnant’ (all pregnant categories), ‘pre-pregnant’ (treatment started before and continued during pregnancy), ‘pregnant’ (treatment started during pregnancy), and ‘postpartum’ (treatment started within 3 months of a live birth). RESULTS Pregnancy and TB co-occurred among 7% of 15,092 individuals. Peri-pregnant people were more likely to be under 30 years old ( P < 0.001), have recently immigrated ( P < 0.001), and have pulmonary TB ( P < 0.001) than nonpregnant people. Pregnant and postpartum people were 2.3 times more likely to have a TB diagnosis lacking microbiological confirmation than pre-pregnant people (95% confidence interval [1.7–3.2]). Pyrazinamide was used for >90% of pre-pregnant and postpartum groups, but 41% ( P < 0.001) for people started on TB treatment while pregnant. CONCLUSION Pregnancy occurs commonly among people of childbearing age with TB in California. Current TB screening practices among pregnant patients might prevent or detect early TB disease.