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      Pregnancy in patients with tuberculosis: a TBNET cross-sectional survey

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          Abstract

          Background

          Objectives: To determine whether the incidence of tuberculosis with pregnancy is more common than would be expected from the crude birth rate; to see whether there is significant delay in the diagnosis of tuberculosis during pregnancy.

          Method

          Design: A cross-sectional survey. Setting: 13 tuberculosis clinics within different European countries and the USA. Population/sample: All patients with tuberculosis seen at these clinics for a period > 1 year. Instrument: Questionnaire survey based on continuous data collection. Main outcome measures: number and proportion of women with tuberculosis who were pregnant; timing of diagnosis in relation to pregnancy, including those who were pregnant or delivered in the 3 months prior to the diagnosis of TB and those who developed TB within 3 months after delivery.

          Results

          Pregnancy occurred in 224 (1.5 %) of 15,217 TB patients and followed the expected rate predicted from the crude birth rate for the clinic populations. TB was diagnosed more commonly in the 3 months after delivery ( n = 103) than during pregnancy ( n = 68; χ 2 = 25.1, P < 0.001).

          Conclusions

          TB is diagnosed more frequently after delivery, despite variations in local TB incidence and healthcare systems.

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          Most cited references23

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          Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a TH2 phenomenon?

          Pregnant females are susceptible to intracellular pathogens and are biased towards humoral rather than cell-mediated immunity. Since TH1 cytokines compromise pregnancy and TH2 cytokines are produced at the maternal-fetal interface, we hypothesize that these TH2 cytokines inhibit TH1 responses, improving fetal survival but impairing responses against some pathogens.
            Bookmark
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            The inverse care law.

            J T Hart (1971)
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              Global tuberculosis report

              (2012)
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                Author and article information

                Contributors
                +44-20 8510 7814 , graham.bothamley@homerton.nhs.uk
                cehlers@fz-borstel.de
                irinasolanka@tut.by
                alena.skrahina@tut.by
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                12 October 2016
                12 October 2016
                2016
                : 16
                : 304
                Affiliations
                [1 ]Department of Respiratory Medicine, Homerton University Hospital, London, E9 6SR UK
                [2 ]TBNET Office, Centre for Research-Borstel, Borstel, Germany
                [3 ]Republican Research and Practical Centre for Pulmonology and TB, Minsk, Belarus
                [4 ]Agència de Salut Pública de Barcelona, Barcelona, Spain
                [5 ]Regional TB Reference Centre, Villa Marelli Institute, Niguarda Ca’Granda Hospital, Milan, Italy
                [6 ]University of Belgrade School of Medicine, Belgrade, Serbia
                [7 ]National Institute for Tuberculosis, Pulmonary Disease and Thoracic Surgery Vyšné Hágy, Ruzomberok, Slovakia
                [8 ]National Pirogov Memorial Medical University, Vinnytsia, Ukraine
                [9 ]Hospitalario Universitario de Pontevedra, Pontevedra, Spain
                [10 ]Beth Israel Deaconess Medical Center, Boston, USA
                [11 ]Department of Infectious Diseases, University of Verona, Verona, Italy
                [12 ]UMC St. Pieter - CHU St. Pierre, Brussels, Belgium
                [13 ]University Hospital of Cattinara, Trieste, Italy
                Article
                1096
                10.1186/s12884-016-1096-4
                5059923
                27729022
                ca497d90-5ce6-4d16-a133-387d40789124
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 14 November 2015
                : 4 October 2016
                Funding
                Funded by: TBNET
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Obstetrics & Gynecology
                tuberculosis,pregnancy,tbnet,diagnosis,postpartum
                Obstetrics & Gynecology
                tuberculosis, pregnancy, tbnet, diagnosis, postpartum

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