Risk of tuberculosis during pregnancy in Mongolia, a high incidence setting with low HIV prevalence

OBJECTIVE : To investigate the epidemiology and the relative risk of tuberculosis (TB) in pregnant women in Mongolia, a high TB incidence setting with a low rate of human immunodeficiency virus co-infection, where active case finding for TB in pregnancy is implemented. DESIGN: We retrospectively collected data on pregnant women diagnosed with TB during 2013. Data were collected through doctors at central TB dispensaries who extracted the relevant information from patients' clinical records. RESULT S : The overall incidence of TB among pregnant women was 228 (95%CI 187-276) per 100 000 personyears, resulting in an incidence rate ratio of 1.31 (95%CI 1.08-1.59) in pregnant women compared to the general population. Twelve per cent of the pregnant women with TB chose to have an abortion. CONCLUS IONS : In this study, pregnant women had a 1.3-fold higher risk of developing TB than the general population. Based on a moderately increased risk of TB during pregnancy in our study and the potential for adverse health outcomes, TB screening among pregnant women can currently be justified, but the cost-effectiveness of this intervention remains unclear. Patients and doctors need to be educated about the safety of standard TB treatment in pregnancy to reduce the rate of abortions.