Tuberculosis During Pregnancy: An Updated Narrative Review

Fahmi Yousef Khan¹, Muad Fahmi Yousef², Musaab Fahmi Yousef³, Mohammed Tareq Yousef⁴

Keywords: tuberculosis, pregnancy, pregnant women, postpartum period, tuberculin test, latenttuberculosis, multidrug-resistant tuberculosis, interferon-gamma release tests, antitubercularagents

DOI: 10.63475/yjm.v5i2.0482

DOI URL: https://doi.org/10.63475/yjm.v5i2.0482

Publish Date: 23-08-2026

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Pages: 303 - 317

Downloads: 2

Citation: 0

Author Affiliation:

1 Assistant Professor/Senior Consultant, Department of Medicine, Hamad General Hospital, Weill Cornell Medical College, Doha, Qatar
2 Medical Student, Medipol University, Istanbul, Turkey
3 Medical Student, University of Jordan, School of Medicine, Amman, Jordan
4 Medical Student, Emirate International University, Faculty of Medicine and Health Sciences, Sana’a, Yemen

Abstract

Tuberculosis is a major global cause of morbidity and mortality, affecting over 200,000 pregnant women each year, although the epidemiology of tuberculosis in pregnancy is not well understood. This article aims to provide an overview of tuberculosis during pregnancy and in the postpartum period. A narrative review of published articles on tuberculosis and pregnancy was conducted through March 2023. Special attention was given to studies published between 2000 and 2023. The following themes were covered: epidemiology, pathophysiology, diagnostic tests, treatment of active and latent tuberculosis, drug-resistant tuberculosis, maternal and perinatal outcomes, and postpartum aspects. Pregnancy-related immunological alterations may contribute to an increased susceptibility to tuberculosis, but may play a minor role in relation to several sociodemographic and clinical factors. Active tuberculosis is associated with an increased risk of maternal mortality, morbidity, and anemia, as well as adverse perinatal outcomes such as premature birth and low birth weight, particularly if associated with HIV infection or if treatment is inadequate. Screening for tuberculosis is based primarily on clinical evaluation, chest X-ray, and immunological tests, with nucleic acid amplification and culture used for definitive diagnosis. In drug-sensitive tuberculosis, first-line anti-tuberculosis drugs are considered safe and effective during pregnancy; however, a personalized all-oral regimen including bedaquiline and linezolid is recommended for multidrug-resistant tuberculosis. Treatment of latent tuberculosis in pregnancy should be individualized according to the risk of tuberculosis progression and potential liver damage. Particular considerations in the postpartum period include breastfeeding and postnatal assessment of the baby. The review concluded that more clinical trials involving pregnant women are needed and that the approach to tuberculosis treatment during pregnancy should be standardized to reduce health inequalities.

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