{
    "abstract": "Multi-drug resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) in pregnant women is a cause for concern globally; few data have described the safety of second-line anti-TB medications during pregnancy. We aim to describe TB treatment and pregnancy outcomes among pregnant women receiving second-line anti-tuberculosis treatment for MDR/RR-TB in Johannesburg, South Africa.\nWe conducted a retrospective record review of pregnant women (\u2265\u200918\u00a0years) who received treatment for MDR/RR-TB between 01/2010-08/2016 at three outpatient treatment sites in Johannesburg, South Africa. Demographic, treatment and pregnancy outcome data were collected from available medical records. Preterm birth (<\u200937\u00a0weeks), and miscarriage were categorized as adverse pregnancy outcomes.\nOut of 720 women of child-bearing age who received MDR/RR-TB treatment at the three study sites, 35 (4.4%) pregnancies were identified. Overall, 68.7% (24/35) were HIV infected, 83.3% (20/24) were on antiretroviral therapy (ART). Most women, 88.6% (31/35), were pregnant at the time of MDR/RR-TB diagnosis and four women became pregnant during treatment. Pregnancy outcomes were available for 20/35 (57.1%) women, which included 15 live births (11 occurred prior to 37\u00a0weeks), 1 neonatal death, 1 miscarriage and 3 pregnancy terminations. Overall, 13/20 (65.0%) women with known pregnancy outcomes had an adverse pregnancy outcome. Of the 28 women with known TB treatment outcomes 17 (60.7%) completed treatment successfully (4 were cured and 13 completed treatment), 3 (10.7%) died and 8 (28.6%) were lost-to-follow-up.\nPregnant women with MDR/RR-TB suffer from high rates of adverse pregnancy outcomes and about 60% achieve a successful TB treatment outcome. These vulnerable patients require close monitoring and coordinated obstetric, HIV and TB care.",
    "authors": [
        {
            "affiliation": "Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. imokhele@heroza.org.",
            "firstname": "Idah",
            "initials": "I",
            "lastname": "Mokhele"
        },
        {
            "affiliation": "Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.",
            "firstname": "Nelly",
            "initials": "N",
            "lastname": "Jinga"
        },
        {
            "affiliation": "Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.\nDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.",
            "firstname": "Rebecca",
            "initials": "R",
            "lastname": "Berhanu"
        },
        {
            "affiliation": "Right To Care, Johannesburg, South Africa.",
            "firstname": "Thandi",
            "initials": "T",
            "lastname": "Dlamini"
        },
        {
            "affiliation": "Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.\nDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.",
            "firstname": "Lawrence",
            "initials": "L",
            "lastname": "Long"
        },
        {
            "affiliation": "Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.",
            "firstname": "Denise",
            "initials": "D",
            "lastname": "Evans"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1186/s12884-021-03956-6\n10.7196/SAMJ.2016.v106i4.10205\n10.5152/TurkThoracJ.2018.17062\n10.1093/cid/cis732\n10.1055/s-2007-993948\n10.1093/cid/ciaa189.pmid:32141495\n10.1086/598191\n10.1016/S2214-109X(18)30451-0\n10.1093/ije/dyx136\n10.1371/journal.pone.0164249\n10.1093/cid/cix851\n10.1093/cid/ciaa805\n10.1093/jac/dkx107\n10.1111/j.1365-2710.1987.tb00539.x\n10.5588/ijtld.18.0626",
    "journal": "BMC pregnancy and childbirth",
    "keywords": [
        "HIV",
        "Multi-drug-resistant tuberculosis",
        "Pregnancy",
        "Rifampicin resistance",
        "Second-line anti-TB treatment",
        "South Africa"
    ],
    "methods": null,
    "publication_date": "2021-06-30",
    "pubmed_id": "34182944\n27032841\n30407162\n22942202\n9643636\n30946559\n32141495\n25320836\n19361302\n30389451\n29040569\n31616571\n27812086\n29028970\n32564058\n28419314\n3119606\n31615608",
    "results": "Out of 720 women of child-bearing age who received MDR/RR-TB treatment at the three study sites, 35 (4.4%) pregnancies were identified. Overall, 68.7% (24/35) were HIV infected, 83.3% (20/24) were on antiretroviral therapy (ART). Most women, 88.6% (31/35), were pregnant at the time of MDR/RR-TB diagnosis and four women became pregnant during treatment. Pregnancy outcomes were available for 20/35 (57.1%) women, which included 15 live births (11 occurred prior to 37\u00a0weeks), 1 neonatal death, 1 miscarriage and 3 pregnancy terminations. Overall, 13/20 (65.0%) women with known pregnancy outcomes had an adverse pregnancy outcome. Of the 28 women with known TB treatment outcomes 17 (60.7%) completed treatment successfully (4 were cured and 13 completed treatment), 3 (10.7%) died and 8 (28.6%) were lost-to-follow-up.",
    "title": "Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa.",
    "xml": "<Element 'PubmedArticle' at 0x78850472e3e0>"
}