Tuberculosis in women who are pregnant or breastfeeding

Women who have TB and are pregnant or breastfeeding should be managed in close consultation with specialists who have appropriate training and experience.

Untreated TB is a greater hazard to a pregnant woman and her fetus than potential adverse effects of treatment. Treat TB in pregnant women with standard short-course therapy—these first-line TB drugs are considered safe in pregnancy, with low risk of teratogenicity.

Breastfeeding should not be discouraged in women receiving TB treatment, but infection control measures are required for mothers with pulmonary TB who are infectious at the time of delivery—see Neonate born to a mother with pulmonary TB during pregnancy who is infectious at delivery. The concentrations of TB drugs in breast milk are very low, so do not provide effective treatment for TB in a breastfed infant. An infant being breastfed by a mother who is taking isoniazid does not require pyridoxine unless the infant is also receiving isoniazid and is exclusively breastfed, has HIV infection or is malnourished.

For discussion on management of neonates born to a mother with TB, see Neonates born to a mother with tuberculosis.

For discussion on treatment of latent TB in women who are pregnant, see Latent tuberculosis.