The authors were interested in the impact of tuberculosis among HIV-infected mothers on obstetric and infant outcomes in a population with access to antiretroviral therapy. They performed a prospective cohort study where HIV-infected pregnant women with and without TB disease were followed from 2011 to 2014 in Soweto, South Africa. Two controls were enrolled for each case, matched by enrolment time, maternal age, gestational age and planned delivery clinic and followed for 12 months post-delivery. The authors recruited 80 cases and 155 controls, resulting in 224 live-born infants. Infants of mothers with HIV and TB disease had a significantly higher risk of low birth weight (20.8% vs. 10.7%), prolonged hospitalisation at birth (51% vs. 16%), infant mortality (68/1000 births vs. 7/1000 births) and TB disease (12% vs. 0%) despite appropriate maternal therapy and infant TB preventive therapy. Obstetric outcomes in coinfected women were also poorer, with significantly higher risks of maternal hospitalisation (25% vs. 11%) and pre-eclampsia (5.5% vs. 0.7%). Therefore TB in HIV infected pregnant women still remains a significant threat to the health of both the mother and infant.
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