Clinical data of 80 pregnant women with active TB hospitalized at Shanghai Public Health Clinical Center between June 1st, 2014 and November 30th, 2020 were extracted and retrospectively analyzed. History of receiving IVF was recorded at admission and its association with maternal and perinatal outcomes were assessed using multivariable logistic regression models with adjustment for potential confounders.
Of the 80 pregnant women with active TB, 28 (35.0%) received IVF treatment and 52 (65.0%) did not receive IVF treatment. After adjusting for potential confounders, receiving IVF was associated with worse maternal and perinatal outcomes, including maternal criticality (21.4 vs. 2.0%, adjusted OR = 28.3, P = 0.015), miliary TB (89.3 vs. 13.5%, adjusted OR = 75.4, P < 0.001), TB meningitis (32.1 vs. 7.7%, adjusted OR = 6.2, P = 0.010), and perinatal mortality (64.3 vs. 28.8%, adjusted OR = 9.8, P = 0.001).
The additional risk of TB to women receiving IVF treatment is a public health challenge specific to countries with a high tuberculosis burden. Increased awareness of latent tuberculosis infection in women receiving IVF treatment is needed.
6月1日在上海市公共卫生临床中心住院的80例活动性结核病孕妇的临床资料,2014年11月30日,2020年进行提取和回顾性分析。入院时记录接受IVF的病史,并使用多变量逻辑回归模型评估其与孕产妇和围产期结局的关系,并校正潜在的混杂因素。
在80名患有活动性结核病的孕妇中,28例(35.0%)接受IVF治疗,52例(65.0%)未接受IVF治疗。在调整了潜在的混杂因素后,接受IVF与更差的孕产妇和围产期结局有关,包括产妇临界性(21.4vs.2.0%,调整后的OR=28.3,P=0.015),恶性肺结核(89.3vs.13.5%,调整后的OR=75.4,P<0.001),结核性脑膜炎(32.1vs.7.7%,调整后的OR=6.2,P=0.010),和围产期死亡率(64.3vs.28.8%,调整后的OR=9.8,P=0.001)。
接受试管婴儿治疗的妇女患结核病的额外风险是结核病负担高的国家特有的公共卫生挑战。需要提高接受IVF治疗的妇女对潜伏性结核感染的认识。