title: [Spanish Society for Pediatric Infectious Diseases guidelines on tuberculosis in pregnant women and neonates (ii): Prophylaxis and treatment].
abstract: In pregnant women who have been exposed to tuberculosis (TB), primary isoniazid prophylaxis is only recommended in cases of immunosuppression, chronic medical conditions or obstetric risk factors, and close and sustained contact with a patient with infectious TB. Isoniazid prophylaxis for latent tuberculosis infection (LTBI) is recommended in women who have close contact with an infectious TB patient or have risk factors for progression to active disease. Otherwise, it should be delayed until at least three weeks after delivery. Treatment of TB disease during pregnancy is the same as for the general adult population. Infants born to mothers with disseminated or extrapulmonary TB in pregnancy, with active TB at delivery, or with postnatal exposure to TB, should undergo a complete diagnostic evaluation. Primary isoniazid prophylaxis for at least 12 weeks is recommended for those with negative diagnostic tests and no evidence of disease. Repeated negative diagnostic tests are mandatory before interrupting prophylaxis. Isoniazid for 9 months is recommended in LTBI. Treatment of neonatal TB disease is similar to that of older children, but should be maintained for at least 9 months. Respiratory isolation is recommended in congenital TB, and in postnatal TB with positive gastric or bronchial aspirate acid-fast smears. Separation of mother and infant is only necessary when the mother has received treatment for less than 2 weeks, is sputum smear-positive, or has drug-resistant TB. Breastfeeding is not contraindicated, and in case of mother-infant separation expressed breast milk feeding is recommended.
authors.affiliation: Grupo de Infección Congénita y Perinatal de la SEIP, Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital Infantil La Paz, Madrid, España. Electronic address: fbaquero@terra.com.
authors.forename: F
authors.initials: F
authors.lastname: Baquero-Artigao
authors.affiliation: Grupo de Tuberculosis de la SEIP, Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital Infantil La Paz, Madrid, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Mellado Peña
authors.affiliation: Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital Infantil La Paz, Madrid, España.
authors.forename: T
authors.initials: T
authors.lastname: del Rosal Rabes
authors.affiliation: Unidad de Infecciones, Servicio de Pediatría, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Noguera Julián
authors.affiliation: Servicio de Medicina Maternofetal, Institut Clínic de Ginecología, Obstetricia i Neonatologia, Hospital Clínic, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Goncé Mellgren
authors.affiliation: Unidad de Tocología de Alto Riesgo, Servicio de Obstetricia y Ginecología, Hospital La Paz, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: de la Calle Fernández-Miranda
authors.affiliation: Sección de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Gregorio Marañón, Madrid, España.
authors.forename: M L
authors.initials: ML
authors.lastname: Navarro Gómez
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007538:Isoniazid / Q000627:therapeutic use*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000517:prevention & control; D014376:Tuberculosis / Q000151:congenital* / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid
keywords: Breast feeding; Congenital; Congénito; Embarazo; Infant, newborn; Infección tuberculosa latente; Isoniazid; Isoniazida; Lactancia materna; Latent tuberculosis; Pregnancy; Recién nacido; Therapeutics; Tratamiento; Tuberculosis