TB treatment during pregnancy safe for mother and baby: study

Seven out of 10 pregnant women were cured of their multidrug-resistant tuberculosis and gave birth to healthy babies after taking a drug previously thought to be dangerous during pregnancy, according to a new study from the Curtin and Telethon Kids Institute.

Published in Open the JAMA networkThe study looked at the experiences of 275 pregnant women with MDR-TB who lived in South Africa, Peru, Brazil, Iran, and Uganda.

Lead researcher Dr. Kefyalew Alene, of the Curtin School of Population Health and the Telethon Kids Institute, said the study found that a drug used to treat multidrug-resistant tuberculosis, linezolid, was associated with favorable pregnancies and a high treatment success.

“This is the first comprehensive review of treatment outcomes for multidrug-resistant TB in pregnant women, who remain one of the most vulnerable groups among the half million people living with the disease worldwide,” said Dr. Allen.

“I was surprised to find that as many as 73.2% of pregnant women with MDR-TB gave birth to healthy babies and that the treatment worked for 72.5% of the women, meaning they ‘have been cured of the disease or have successfully completed treatment. »

Dr. Alene said the study answered a difficult global problem of when to treat pregnant patients living with multidrug-resistant tuberculosis.

“Second-line anti-TB drugs used to treat MDR-TB are considered to be toxic to the fetus and previous research has suggested waiting until treatment is given after birth,” said Dr. Alene.

“Tuberculosis can have a more devastating impact on mothers and babies than drug side effects. If MDR-TB is not treated, it could lead to risk of maternal illness and maternal and fetal death.

“This study shows that we should start treatment as early as possible during pregnancy. However, more research is needed on the use of linezolid during pregnancy because long-term use may increase the risk of gastrointestinal disorders, ototoxicity, and psychiatric disorders. »

The remaining proportion of adverse pregnancy outcomes, including preterm birth, pregnancy loss, low birth weight, and stillbirth, were not caused by the drug but by the disease itself. The researchers concluded that if the drug was not taken, the outcome would be worse.

This study was supported by a research grant from the Australian National Council for Health and Medical Research.

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