title: Universal tuberculosis screening in pregnancy.
abstract: We reviewed our practice of universal tuberculosis (TB) screening in an at-risk pregnant population with regards to utility and patient compliance. The Gouverneur Healthcare Services prenatal database was analyzed for compliance with TB screening. Age, ethnicity, country of origin, and education level were also analyzed. Of 4049 patients, 95.0% were compliant with their purified protein derivative (PPD) testing. Universal screening identified 1935 (50.4%) PPD+ patients, with chest X-rays (CXR) available for 95.1%. Only one patient had a CXR consistent with active TB, although sputum testing was negative for acid-fast bacilli. Asian women were more likely to be PPD-compliant (adjusted odds ratio [aOR]: 4.94, 95% confidence interval [CI]: 2.34 to 10.45). Similarly, PPD+ Asian women were more likely to be compliant with CXR (aOR: 12.67, 95% CI: 3.44 to 46.7). U.S.-born women were significantly less likely to be compliant with PPD (aOR: 0.44, 95% CI: 0.30 to 0.64) or with CXR (aOR: 0.22, 95% CI: 0.08 to 0.61). Universal prenatal TB screening is associated with excellent compliance rates and is an effective way to identify a high prevalence of latent TB, but not active disease.
authors.affiliation: Department of Obstetrics and Gynecology, NYU School of Medicine, New York, New York 10016, USA. nadavmd@hotmail.com
authors.forename: Nadav
authors.initials: N
authors.lastname: Schwartz
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Wagner
authors.forename: Sean M
authors.initials: SM
authors.lastname: Keeler
authors.forename: Julian
authors.initials: J
authors.lastname: Mierlak
authors.forename: David E
authors.initials: DE
authors.lastname: Seubert
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult