TB and Pregnancy

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What is TB?

Tuberculosis or TB is a bacterium which can affect any part of your body, but most often affects the lungs.

If you are infected, you are not likely to feel sick or show any symptoms right away. Usually your immune system will be able to kill the germ. If not, it will remain in your body, but may develop into active TB later if your immune system becomes weak. People with a lower level of immunity, like babies and young children, are more likely to have active TB.


How common is TB in India?

India has the largest number of TB cases in the world. Every year nearly 2 million people get TB disease. Whether you are pregnant or not, you have a one in 600 risk of getting TB. TB is more common in the north than in the south, and in urban areas than in rural areas.


How does TB spread?

Only people who have an active infection of TB in the lungs are infectious. When they sneeze or cough, TB is spread, quite like the common cold. When a person breathes in TB, it settles in the lungs and begins to grow. It then moves through the blood to other parts of the body like the kidney, spine and brain.

You are most likely to get TB if you have a low immunity level and spend a long period of time in close contact with an infected person. So merely a brief contact with an infected person while, say, commuting on buses or trains, watching a movie in a theatre, sharing food, talking or shaking hands, will not give you TB.

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What happens if I catch TB?

If you are infected by the bacterium there are three things that can happen:

• Your immune system usually kills off the bacteria completely.
• Your immune system may build a defensive barrier around the TB, but the bacteria remains in your body. This is latent TB.
• The infection spreads to your lungs. This is active TB.

In the majority of cases, the bacteria are killed off by your immune system. If you have latent TB it is possible for the infection to flare up again and spread if your immune system is weakened.


When am I at risk of getting active TB?

Anyone can catch TB. But you are particularly at risk if:

• You live in an environment where there are many TB cases.
• You have been in close contact with someone who has active TB, such as family members, relatives, friends or household help.
• You have an illness which makes you less able to fight off an infection.
• You are either very young or very old.
• You have poor health due to improper diet, alcoholism, drug abuse or homelessness.
• You live in poor or crowded housing conditions.

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What are the symptoms of TB?

Common symptoms of TB include:

• persistent cough for more than three weeks
• fever
• weight loss
• fatigue
• breathlessness
• loss of appetite
• nausea
• night sweats

Some of these symptoms such as tiredness and nausea are common symptoms of pregnancy. If you have any risk factors for TB and experience any of these symptoms it is worth checking with your doctor.

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What if my doctor suspects a TB infection and I’m pregnant?

If you are preg​nant and you are coughing up sputum (phlegm), you will be asked to do a sputum test. This involves taking a sample of the phlegm and checking for the presence of TB. This may be followed by a chest x-ray, skin test or blood test. The impact that undetected and untreated TB will have on your baby is greater than any harm that an x-ray will have on your baby.

If you have no specific symptom of TB, you will be given the Tuberculin skin test. Also called the Mantoux test, it identifies if you have ever been exposed to TB. The test involves an injection in your skin. If after 2-3 days the area shows a large swelling it indicates the presence of the TB bacteria, but not necessarily an active infection.


How can TB affect me and my unborn baby?

If you are pregnant with TB, there is a risk of your baby being born prematurely and of low birth weight, if you don’t diagnose and treat it early enough. There is also a very small risk of your baby being born with TB.


Treatment of TB

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Treatment of TB

TB is 100% curable if it is detected early and if the full course of medicines is taken without interruption. It takes at least 6 months to kill TB. You may feel better within a few weeks of treatment, but the bacteria are still alive. So it is important to complete the full course of medication.

Pregnant women should start treatment as soon as TB is detected. This greatly reduces the chances of you becoming ill during pregnancy, and of your baby being born too early or too small.


Why should you not give up TB medication midway?


If you do not take the drugs as exactly prescribed, there is a very strong chance of a relapse. And you could pass the infection on to your family members.

You may also end up with drug-resistant forms of the disease which are more difficult to treat. So you must complete the full course of treatment.

Medications for TB need to be taken over a long period — anywhere between 4-9 months —depending on the severity of your case. Your doctor will tell you when it is safe to stop medication.

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Can I breastfeed my baby if I am undergoing treatment for TB?

A small concentration of the TB drugs does get into breast milk, but research indicates that levels are so low that it will not affect your baby. The benefits of breastfeeding far outweigh any possible side effects of medication. Talk to your doctor if you are worried about this.


I’m pregnant and I’ve been diagnosed with TB. How do I take care of myself?

• Eat a well balanced diet and get plenty of fresh air.
• Ensure you take all your medicines and do not miss even a single dose of what has been prescribed.
• Make sure you don’t miss any antenatal visits and other doctor’s appointments.
• Report any side effects, such as vision changes, headaches or increased nausea to your doctor immediately.
• Maintain good personal hygiene . Ensure that you wash your hands regularly and cover your mouth and nose with a tissue when you cough or sneeze so that you do not spread the germs around.
• Make sure you dispose of your soiled tissues in a covered bin.

It is important to stay positive – it is safer for you and your baby to be aware of the illness and get treated for it than to be ignorant and suffer from failing health and end up in life threatening situations.


Can my baby catch TB from me once he is born?

Your baby can catch TB from you only if you have active TB in the lungs and have not begun treatment. Once you have been taking medication for two weeks you can no longer infect other people. Your baby will be tested for TB at birth and treated if he has become infected. If he is TB free he will be given the BCG vaccine to protect him against TB.

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