BJOG Release: Study Highlights Lack Of Awareness About TB In Pregnancy

Main Category: Tuberculosis
Also Included In: Pregnancy / Obstetrics
Article Date: 18 Feb 2009 - 7:00 PDT

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A national study to be published in BJOG: An International Journal of Obstetrics and Gynaecology has highlighted a lack of awareness about Tuberculosis (TB) in pregnancy. The study found that ethnic minority women, particularly those who have recently arrived in the UK, are most commonly affected.

The number of women who die from TB during pregnancy is increasing in the UK. TB has been classified as a priority infectious disease, and TB incidence in the UK is now higher than that in most western European countries.

In this study, researchers identified cases of TB during pregnancy using the UK Obstetric Surveillance System (UKOSS). Cases of TB were recorded between August 2005 and August 2006. All 229 of eligible UK hospitals participated, representing 100% coverage of women giving birth in the UK.

During this period, a total of 33 women were diagnosed with TB during pregnancy. All of these women were non-white. Researchers found that TB in pregnancy in the UK appears to be exclusively limited to ethnic minority women and almost exclusively to those born outside the UK.

The authors noted that screening for TB during pregnancy, while recommended, does not seem to be undertaken routinely. This may contribute to a delay in diagnosis.

The increase in TB incidence may be due to a lack of awareness of TB in pregnancy among obstetric and midwifery staff. It is particularly important to remain alert to the diagnosis in ethnic minority women.

Lead author, Dr. Marian Knight, Senior Clinical Research Fellow and Honorary Consultant in Public Health at the National Perinatal Epidemiology Unit, University of Oxford, said, "This national study shows that for every woman who dies from TB in pregnancy, more than thirty have TB and survive. Importantly, there are differences in the pattern of TB in pregnant women compared to the non-pregnant population. Ethnic minority women, particularly those who have recently arrived in the UK, are most commonly affected."

"Both women and their doctors and midwives should be aware that the symptoms of TB in pregnancy may be different, and consider the diagnosis, especially in recently arrived immigrant women, presenting with non-specific symptoms."

Prof. Philip Steer, BJOG editor-in-chief, said "The increased incidence of TB among pregnant ethnic minority women raises serious concerns about access to services and quality of care. These findings call upon all health professionals involved in the care of pregnant women to remain alert to the possibility of TB within this population.

"Proper screening remains essential to ensuring the timely diagnosis of TB during pregnancy, and to preventing further maternal deaths."

Notes

BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Wiley-Blackwell. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote 'BJOG' or 'BJOG: An International Journal of Obstetrics and Gynaecology' when referring to the journal and include the website: www.bjog.org as a hidden link online.

Reference

Knight M, Kurinczuk J, Nelson-Piercy C, Spark P, Brocklehurst P on behalf of UKOSS. Tuberculosis in pregnancy in the UK. BJOG 2009; DOI: 10.1111/j.1471-0528.2008.02097.x.

Royal College of Obstetricians and Gynaecologists

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