Imperial College London
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Professor James Seddon

Faculty of Medicine, Department of Infectious Disease

Professor of Global Child Health
 
 
 
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Contact

 

+44 (0)20 7594 3179james.seddon

 
 
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Location

 

235Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Loveday:2021:cid/ciaa189,
author = {Loveday, M and Hughes, J and Sunkari, B and Master, I and Hlangu, S and Reddy, T and Chotoo, S and Green, N and Seddon, J},
doi = {cid/ciaa189},
journal = {Clinical Infectious Diseases},
pages = {1158--1168},
title = {Maternal and infant outcomes among pregnant women treated for multidrug/rifampicin-resistant tuberculosis in South Africa},
url = {http://dx.doi.org/10.1093/cid/ciaa189},
volume = {72},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundData on safety and efficacy of second-line tuberculosis drugs in pregnant women and their infants are severely limited due to exclusion from clinical trials and expanded access programmes.MethodsPregnant women starting treatment for multidrug/rifampicin-resistant (MDR/RR)-tuberculosis at King Dinuzulu Hospital in KwaZulu-Natal, South Africa from 1 January 2013 – 31 December 2017 were included. We conducted a record review to describe maternal treatment and pregnancy outcomes, and a clinical assessment to describe infant outcomes.ResultsOf 108 pregnant women treated for MDR/RR-tuberculosis, 88 (81%) were HIV-infected. Favourable MDR/RR-tuberculosis treatment outcomes were reported in 72 (67%) women. Ninety-nine (91%) of the 109 babies were born alive but, overall, 52 (48%) women had unfavourable pregnancy outcomes. Fifty-eight (54%) women received bedaquiline and 49 (45%) babies were exposed to bedaquiline in utero. Low birthweight was reported in more babies exposed to bedaquiline compared to babies not exposed (45% vs 26%; p=0.034). In multivariate analyses, bedaquiline and levofloxacin, drugs often used in combination, were both independently associated with increased risk of low birthweight. Of the 86 children evaluated at 12 months, 72 (84%) had favourable outcomes; 88% of babies exposed to bedaquiline were thriving and developing normally compared to 82% of the babies not exposed.ConclusionsMDR/RR-tuberculosis treatment outcomes among pregnant women were comparable to non-pregnant adults. Although more babies exposed to bedaquiline were of low birthweight, over 80% had gained weight and were developing normally at one year.
AU  - Loveday,M
AU  - Hughes,J
AU  - Sunkari,B
AU  - Master,I
AU  - Hlangu,S
AU  - Reddy,T
AU  - Chotoo,S
AU  - Green,N
AU  - Seddon,J
DO  - cid/ciaa189
EP  - 1168
PY  - 2021///
SN  - 1058-4838
SP  - 1158
TI  - Maternal and infant outcomes among pregnant women treated for multidrug/rifampicin-resistant tuberculosis in South Africa
T2  - Clinical Infectious Diseases
UR  - http://dx.doi.org/10.1093/cid/ciaa189
UR  - https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa189/5788430
UR  - http://hdl.handle.net/10044/1/77881
VL  - 72
ER  -
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