Adverse neonatal outcome associated with maternal
\ntuberculosis in a public tertiary centre: a retrospective
\ncohort study

Introduction: The aim of this study was to evaluate a group
\nof infants born to women with tuberculosis (TB) during
\npregnancy to determine the neonatal morbidities and its
\noutcomes associated with tuberculosis in pregnancy.
\nMaterials and Methods: Data from January 2007 to
\nDecember 2021 was collected for analysis as part of a
\nretrospective cohort study. This study was conducted in a
\ntertiary public hospital in Malaysia, Hospital Sultan Idris
\nShah (HSIS). Cases were identified from the hospital’s
\nbacille Calmette-Guerin (BCG) vaccination notification
\nforms and merged with records from the neonatal intensive
\ncare unit’s census. Controls were infants born to mothers
\nunaffected by TB within the same hospital and year as the
\nindex case (1:4 ratio). Descriptive statistics and logistic
\nregression were used to analyse the data. The main outcome
\nmeasures were the risk of congenital tuberculosis,
\npremature birth, low birth weight, small for gestational age
\nand low APGAR score.
\nResults: Infants born to mothers with TB exhibited a twofold increased risk of low birth weight (Odds Ratio, OR: 2.51;
\n95% Confidence Interval, 95%CI: 1.31, 4.81), with an even
\nhigher risk (OR: 3.29; 95%CI: 1.637, 6.612) if active TB was
\ndiagnosed during the index pregnancy. These infants also
\nhad an elevated risk of being small for gestational age
\ncompared to infants born to healthy mothers (OR: 2.48;
\n95%CI:1.15, 5.39). Furthermore, adverse outcomes were also
\nmore frequently detected among infants of mothers with
\npulmonary TB compared to those with extra-pulmonary TB.
\nInfants born to mothers with PTB were more likely to be born
\nwith low birth weight (OR: 1.60; 95%CI: 1.095, 2.339). No
\ncases of congenital TB were reported throughout the entire
\nstudy period.