TB and Pregnancy
TB Disease in Pregnancy
While dealing with a TB diagnosis in pregnancy is not easy, there is a greater risk to the pregnant woman and her baby if TB disease is not treated. Babies born to women with untreated TB disease may have lower birth weight than those babies born to women without TB. Rarely, a baby may be born with TB.
Testing for TB Infection for Pregnant Women
Pregnant women at high risk for developing TB disease should be tested for TB infection. Generally, pregnant women at high risk for developing TB disease include:
- Persons who have been recently infected with TB bacteria
- Persons with medical conditions that weaken the immune system
The tuberculin skin test is both safe and reliable to use throughout pregnancy. The TB blood test is safe to use during pregnancy, but has not been fully evaluated for diagnosing TB infection in pregnant women. Therefore, TB blood test results should be interpreted with the help of a TB expert.
If a tuberculin skin test or TB blood test is positive, other tests are needed to diagnose TB disease. Healthcare providers should obtain a chest radiograph using proper shielding.
Latent TB Infection and TB Disease Treatment for Pregnant Women
Treatment for Latent TB Infection
For most pregnant women, treatment for latent TB infection can be delayed until 2–3 months post-partum to avoid administering unnecessary medication during pregnancy. However, for pregnant women who are at high risk for progression from latent TB infection to TB disease, especially those who are a recent contact of someone with infectious TB disease, treatment for latent TB infection should not be delayed on the basis of pregnancy alone, even during the first trimester.
Treatment for TB Disease
Pregnant women who are diagnosed with TB disease should start treatment as soon as possible. Although the TB drugs used in treatment cross the placenta, these drugs do not appear to have harmful effects on the baby.
Treatment Regimens for Latent TB Infection and TB Disease
|Latent TB Infection||
|HIV-Related TB Disease||
The following antituberculosis drugs are contraindicated in pregnant women
Women who are being treated for drug-resistant TB should receive counseling concerning the risk to the baby because of the known and unknown risks of second-line antituberculosis drugs.
Breastfeeding is not contraindicated in women taking INH or RIF separately. Supplementation of pyridoxine (vitamin B6) is recommended for nursing women and for breastfed infants. The amount of INH or RIF in breast milk is inadequate for treatment of infants with LTBI.
RIF can cause orange discoloration of body fluids, including breast milk. Orange discoloration of body fluids is expected and harmless.
There currently is not enough data to indicate whether the 3HP regimen is safe for women to take while breastfeeding.
- Treatment for TB Disease and Pregnancy
- Testing During Pregnancy
- Staying on Track with TB Medicine [PDF – 8MB] (Pamphlet)