Journal Article

Drug-Resistant Tuberculosis and Pregnancy: Treatment Outcomes of 38 Cases in Lima, Peru

Eda Palacios, Rebecca Dallman, Maribel Muñoz, Rocio Hurtado, Katiuska Chalco, Dalia Guerra, Lorena Mestanza, Karim Llaro, Cesar Bonilla, Peter Drobac, Jaime Bayona, Melissa Lygizos, Holly Anger and Sonya Shin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 48, issue 10, pages 1413-1419
Published in print May 2009 | ISSN: 1058-4838
Published online May 2009 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/598191
Drug-Resistant Tuberculosis and Pregnancy: Treatment Outcomes of 38 Cases in Lima, Peru

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Background.Multidrug-resistant tuberculosis (MDR-TB) disproportionately affects young adults, including women of childbearing age; however, treatment of MDR-TB during pregnancy is still controversial. This study looks at the treatment and pregnancy outcomes in a cohort of women who were treated for MDR-TB during pregnancy during a period of 10 years.

Methods.A retrospective case study was performed using a standardized data collection form and data from 3 ranked sources of patient records. All 38 participants were treated during pregnancy with individualized regimens that included second-line TB medications. We examined the frequency of favorable and adverse outcomes with regard to disease and pregnancy.

Results.After completion of MDR-TB treatment, 61% of the women were cured, 13% had died, 13% had defaulted, 5% remained in treatment, and 5% had experienced treatment failure. Four of the women experienced clinical deterioration of TB during pregnancy. Five of the pregnancies terminated in spontaneous abortions, and 1 child was stillborn. Among the living newborns, 3 were born with low birth weight, 1 was born prematurely, and 1 had fetal distress.

Conclusions.The rates of success in treating MDR-TB in our cohort are comparable to those of other MDR-TB treatment programs in Peru. The birth outcomes of our cohort are similar to those among the general Peru population. Therefore, we advocate that a woman should be given the option to continue treatment of MDR-TB rather than terminating pregnancy or discontinuing MDR-TB treatment.

Journal Article.  4063 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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