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. 2009 May 15;48(10):1413-9.
doi: 10.1086/598191.

Drug-resistant tuberculosis and pregnancy: treatment outcomes of 38 cases in Lima, Peru

Eda Palacios  1 , Rebecca Dallman, Maribel Muñoz, Rocio Hurtado, Katiuska Chalco, Dalia Guerra, Lorena Mestanza, Karim Llaro, Cesar Bonilla, Peter Drobac, Jaime Bayona, Melissa Lygizos, Holly Anger, Sonya Shin
Affiliations

Drug-resistant tuberculosis and pregnancy: treatment outcomes of 38 cases in Lima, Peru

Eda Palacios et al. Clin Infect Dis. .

Abstract

Background: Multidrug-resistant tuberculosis (MDR-TB) disproportionately affects young adults, including women of childbearing age; however, treatment of MDR-TB during pregnancy is still controversial. This study looks at the treatment and pregnancy outcomes in a cohort of women who were treated for MDR-TB during pregnancy during a period of 10 years.

Methods: A retrospective case study was performed using a standardized data collection form and data from 3 ranked sources of patient records. All 38 participants were treated during pregnancy with individualized regimens that included second-line TB medications. We examined the frequency of favorable and adverse outcomes with regard to disease and pregnancy.

Results: After completion of MDR-TB treatment, 61% of the women were cured, 13% had died, 13% had defaulted, 5% remained in treatment, and 5% had experienced treatment failure. Four of the women experienced clinical deterioration of TB during pregnancy. Five of the pregnancies terminated in spontaneous abortions, and 1 child was stillborn. Among the living newborns, 3 were born with low birth weight, 1 was born prematurely, and 1 had fetal distress.

Conclusions: The rates of success in treating MDR-TB in our cohort are comparable to those of other MDR-TB treatment programs in Peru. The birth outcomes of our cohort are similar to those among the general Peru population. Therefore, we advocate that a woman should be given the option to continue treatment of MDR-TB rather than terminating pregnancy or discontinuing MDR-TB treatment.

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Figures

Figure 1
Figure 1
Baseline Resistance to Drugs, N=38
Figure 2
Figure 2
Frequency of Use in Initial MDR-TB Treatment Regimens, N=38
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