Tuberculosis, fertility and pregnancy: the clinical and experimental aspects

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Abstract

The epidemiological situation for tuberculosis in the Russian Federation has improved over the last decade. However, fertility potential and unplanned pregnancy in women in detection and treatment of tuberculosis (TB) of the respiratory organs raise concern.

Objective: To explore the relationship between unplanned pregnancy and the course of TB of the respiratory organs in women and assess the influence of tuberculosis infection on fertility of BALB/c female mice to develop a clinical and experimental concept for a possibility of getting pregnant with favorable perinatal outcomes.

Materials and methods: Observational cross-sectional study was carried out at the Central Research Institute of Tuberculosis. The study included 164 patients, who were divided into 2 groups. Group 1 included 82 pregnant women, who had TB of the respiratory organs. Group 2 included 82 non-pregnant women, who had TB of the repiratory organs. The experimental research was conducted using 40 BALB/c female mice. The mice were divided into 2 groups. Group 1 included 20 pregnant mice infected with Mtb. Group 2 included 20 pregnant mice, but not infected with Mtb.

Results: Active TB disease suppresses the reproductive potential in BALB/c female mice. In women, who have TB of the respiratory organs, unfavorable social and fertility factors increase the risk of unplanned pregnancy by 3.5 times, that aggravates the course of tuberculosis compared with non-pregnant patients. Late relapses occur by 2.5 times more often, exudative pleurisy and bronchial tuberculosis by 1.7 times, late detection of cavernous pulmonary tuberculosis by 5.5 times. The reverse negative impact of TB of the respiratory organs on the course of pregnancy, delivery and the postpartum period was not detected.

Conclusion: The scientifically based interdisciplinary approach to pregnancy management, taking into account unfavorable social and fertility factors in women with TB of the respiratory organs, makes it possible to achieve high efficacy of anti-tuberculosis therapy, to reduce the frequency of obstetric complications, and to have favorable perinatal outcomes.

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About the authors

Svetlana I. Kayukova

Central Research Institute of Tuberculosis; Pirogov Russian National Research Medical University, Ministry of Health of Russia

Author for correspondence.
Email: kajukovalnp@gmail.com
ORCID iD: 0000-0002-5233-3515

Dr. Med. Sci., obstetrician-gynecologist at the Center for diagnostics and rehabilitation of respiratory diseases, Central Research Institute of Tuberculosis; Professor at the Department of Phthisiology, N.I. Pirogov Russian National Research Medical University, Ministry of Health od Russia

Russian Federation, 107564, Moscow, Yauzskaya alley, 2; 117513, Moscow, Ostrovityanov str., 1

Valentina A. Ulyumdzhieva

Central Research Institute of Tuberculosis

Email: amulek@bk.ru
ORCID iD: 0009-0005-8037-249X

PhD student

Russian Federation, 107564, Moscow, Yauzskaya alley, 2

Elena V. Kulakova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_kulakova@oparina4.ru
ORCID iD: 0000-0002-4433-4163

PhD, Senior Researcher at the Prof. B.V. Leonov Department of IVF

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Boris V. Nikonenko

Central Research Institute of Tuberculosis

Email: boris.nikonenko52@gmail.com
ORCID iD: 0000-0003-3205-8197

Leading Researcher at the Department of Immunology

Russian Federation, 107564, Moscow, Yauzskaya alley, 2

Yulia A. Fortygina

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: yu_fortygina@oparina4.ru
ORCID iD: 0000-0002-1251-0505

PhD student

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Svetlana P. Shchelykalina

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: svetlanath@inbox.ru
ORCID iD: 0000-0003-3292-8949

PhD, Associate Professor at the Department of Medical Cybernetics and Computer Science named after S.A. Gasparyan MBF

Russian Federation, 117513, Moscow, Ostrovityanov str., 1

Natalya L. Karpina

Central Research Institute of Tuberculosis

Email: natalya-karpina@rambler.ru
ORCID iD: 0000-0001-7800-8158

 Dr. Med. Sci., Associate Professor, Deputy Director for Science

Russian Federation, 107564, Moscow, Yauzskaya alley, 2

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