TB Risk Higher For Post-Natal Women, Warn Experts

Women who have recently given birth have an increased risk of contracting tuberculosis (TB), a new UK-wide study has found.

A joint study between scientists at the Health Protection Agency (HPA) and the University of East Anglia, published in the American Journal of Respiratory and Critical Care Medicine, found a higher risk of TB in the first six months after pregnancy. No marked increase in risk during pregnancy was observed.

The group analysed data from the General Practice Research Database on all pregnant women between 1996 and 2008. In a group totalling 192,801 women, who had 264,136 pregnancies over the 12-year period, there were 177 cases of TB.

After adjusting for age, region and socio-economic status, the researchers calculated that the rate of TB among pregnant and post-natal women was 15.4 per 100,000 people, considerably higher than the rate of 9.1 per 100,000 outside pregnancy.

Dr Dominik Zenner, a consultant in public health at the HPA who authored the report, said: "The aim of this study was to establish whether pregnancy increases the risk of TB and this was the first primary care-based study to quantify the risk of TB during pregnancy and post pregnancy.

"Although we found a significantly increased risk of TB in the six months following pregnancy, but not during pregnancy, the risk during pregnancy is nonetheless likely to be increased.

"This is in keeping with the observation that pregnant women are disproportionately affected by other respiratory illnesses such as flu. The reason why more post-natal women were diagnosed with TB than pregnant women could be because the TB infection wasn't picked up during pregnancy.

"We hope these findings will encourage those looking after pregnant women to consider possible TB infection in women presenting with symptoms to avoid delays in diagnosis."

Ibrahim Abubakar, head of TB surveillance at the HPA and Professor of Infectious Disease Epidemiology at the University of East Anglia said: "This study clearly shows that future guidance to healthcare workers, especially midwives and health visitors, should take into account that the risk of TB may be increased during pregnancy or shortly after giving birth.

"Those looking after pregnant and post-natal women should be encouraged to look out for the signs and symptoms of the disease, particularly among women in high-risk groups such as immigrants from countries with a high burden of TB, as early diagnosis and appropriate treatment is essential."