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Tuberculosis diagnosed during pregnancy: a prospective study from London
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posted on 2023-06-09, 02:54 authored by Martin LlewelynMartin Llewelyn, Ian Cropley, Robert J Wilkinson, Robert N DavidsonBACKGROUND A study was undertaken to characterise the presentation of tuberculosis in pregnancy and the difficulties in diagnosis in an area of the UK with a high incidence of tuberculosis. METHODS A prospective case series was investigated at Northwick Park Hospital, a university affiliated district general hospital in Brent and Harrow health authority in north-west London which incorporates a regional infectious diseases unit. Patients diagnosed with tuberculosis over the study period were included if the onset of symptoms occurred during pregnancy. RESULTS Thirteen patients were diagnosed during a 30 month period from December 1995 to May 1998 during which 9069 mothers were delivered, a prevalence of 143.3/100 000 deliveries. Symptoms began at a median of 22 weeks gestation (range 9-40 weeks). All patients were recent immigrants of Indian subcontinent or Somali origin and their median duration of residence in the UK was 31 months (range 1-72). Prevalence broken down for racial origin of mothers was 466.3/100 000 for mothers of black African origin and 239.1/100 000 for mothers of Indian origin. Nine of the 13 patients had extrapulmonary tuberculosis. Four patients with widely disseminated disease had a negative Mantoux response and five with localised disease had a strongly positive Mantoux response. HIV co-infection was absent. The median delay between the onset of symptoms and diagnosis was seven weeks (range 2-30). The response to standard treatment was excellent and all patients were cured. CONCLUSIONS Tuberculosis occurring in pregnancy is common in recent immigrants. Diagnosis during pregnancy is delayed because the disease is frequently extrapulmonary with few symptoms.
History
Publication status
- Published
Journal
ThoraxISSN
0040-6376Publisher
BMJ Publishing Group LtdExternal DOI
Issue
2Volume
55Page range
129-132Department affiliated with
- Global Health and Infection Publications
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- No
Peer reviewed?
- Yes
Legacy Posted Date
2016-10-03Usage metrics
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