title: Maternal and perinatal mortality and morbidity associated with tuberculosis during pregnancy and the postpartum period: a systematic review and meta-analysis.
abstract: BACKGROUND
  There is a dearth of data on the clinical features and outcomes of active tuberculosis (TB) in pregnancy. Studies have shown varied results and the relationship between TB and adverse pregnancy outcomes remains unclear.
  
  
  OBJECTIVE
  We conducted a systematic review and meta-analysis to evaluate pregnancy outcomes associated with TB.
  
  
  METHODS
  Major databases were searched from inception until December 2015 without restrictions using the terms: 'TB', 'pregnancy', 'maternal morbidity', 'mortality' and 'perinatal morbidity', 'mortality'.
  
  
  METHODS
  We included studies that compared the outcomes of pregnant women with and without active TB.
  
  
  METHODS
  We computed odds ratios for maternal and perinatal complications, and pooled them using a random effects model. We assessed for heterogeneity using chi-squared tests and evaluated its magnitude using the I2statistic. We used the Newcastle-Ottawa scale for quality assessment.
  
  
  RESULTS
  Thirteen studies, including 3384 pregnancies with active TB and 119 448 without TB were included. Compared with pregnant women without TB, pregnant women with active TB was associated with increased odds of maternal morbidity [odds ratio (OR) 2.8, 95% CI 1.7-4.6; I2= 60.3%], anaemia (OR 3.9, 95% CI 2.2-6.7; I2= 29.8%), caesarean delivery (OR 2.1, 95% CI 1.2-3.8; I2= 61.1%), preterm birth (OR 1.7, 95% CI 1.2-2.4; I2= 66.5%), low birth weight (OR 1.7, 95% CI 1.2-2.4; I2= 53.7%), birth asphyxia (OR 4.6, 95% CI 2.4-8.6; I2= 46.3), and perinatal death (OR 4.2, 95% CI 1.5-11.8; I2= 57.2%).
  
  
  CONCLUSIONS
  Active TB in pregnancy is associated with adverse maternal and fetal outcomes. Early diagnosis of TB is important to prevent significant maternal and perinatal complications.
  
  
  CONCLUSIONS
  Active tuberculosis in pregnancy is associated with adverse maternal and perinatal outcomes.
authors.affiliation: Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Sobhy
authors.affiliation: Department of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK.|Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Babiker
authors.affiliation: Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.|Multidisciplinary Evidence Synthesis Hub (mEsh), Centre of Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK.|Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS) and CIBER Epidemiology and Public Health, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Zamora
authors.affiliation: Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.|Multidisciplinary Evidence Synthesis Hub (mEsh), Centre of Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK.
authors.forename: K S
authors.initials: KS
authors.lastname: Khan
authors.affiliation: Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Kunst
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008428:Maternal Mortality; D054238:Perinatal Mortality; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000401:mortality*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D014376:Tuberculosis / Q000401:mortality*
keywords: Active; maternal; perinatal; pregnancy outcomes; tuberculosis