Department of Infectious Diseases, Sahlgrenska University Hospital, SE-416 85 Gothenburg, Sweden.
Department of Infectious Diseases, Sahlgrenska University Hospital, SE-416 85 Gothenburg, Sweden; Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, P.O Box 480, SE-405 30 Gothenburg, Sweden.
Int J Infect Dis. 2020 Sep;98:138-143. doi: 10.1016/j.ijid.2020.06.069. Epub 2020 Jun 24.
Few studies have focused on the treatment of tuberculosis (TB) during pregnancy. This study aimed to evaluate the risk of adverse events, particularly liver toxicity, in pregnant women during treatment for active TB.
We conducted a retrospective study on pregnant and age-matched non-pregnant women receiving treatment for active TB at four hospitals in Western Sweden between 1992 and 2017.
A total of 135 women were included, 40 pregnant and 95 non-pregnant. The frequency of severe hepatotoxicity was 40% in pregnant women and 6% among non-pregnant women (p < 0.001) (odds ratio 9.9; 95% confidence interval 3.5-28.0). Temporary drug withdrawal due to elevated transaminase levels was more frequent for pregnant than non-pregnant women (40% vs 9.5%; p < 0.001) (odds ratio 6.4; 95% confidence interval 2.5-16.2). There was one fatal case of hepatotoxicity in a pregnant woman.
Severe hepatotoxicity was significantly more frequent in pregnant women compared to non-pregnant women. Careful monitoring of liver transaminases while receiving TB treatment during pregnancy is mandatory, as well as ensuring adequate measures with adjustment of drug regimen and temporary drug withdrawals when a rise in liver enzymes is noted.
很少有研究关注妊娠期间的结核病（TB）治疗。本研究旨在评估活动性 TB 治疗期间孕妇发生不良事件（尤其是肝毒性）的风险。
我们对 1992 年至 2017 年期间在瑞典西部四家医院接受活动性 TB 治疗的妊娠和年龄匹配的非妊娠妇女进行了回顾性研究。
共纳入 135 名女性，40 名孕妇，95 名非孕妇。孕妇中严重肝毒性的发生率为 40%，而非孕妇中为 6%（p<0.001）（比值比 9.9；95%置信区间 3.5-28.0）。由于转氨酶升高而暂时停药的孕妇比非孕妇更常见（40% vs 9.5%；p<0.001）（比值比 6.4；95%置信区间 2.5-16.2）。有一名孕妇发生了致命性肝毒性病例。
与非孕妇相比，孕妇严重肝毒性的发生率明显更高。妊娠期间接受 TB 治疗时必须密切监测肝转氨酶，并且当发现肝酶升高时，必须采取适当的措施调整药物方案和暂时停药。
