SynthesisThe Lancet. Global health2026
Global estimates of tuberculosis incidence during pregnancy and postpartum: a rapid review and modelling analysis.
Synthesis in The Lancet. Global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Safety of Short-course Weekly Rifapentine and Isoniazid (3HP) for TB Preventive Treatment at Conception and During First Trimester in Women With HIV: A Secondary Analysis of the WHIP3TB trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Pharmacokinetics of Efavirenz in Pregnancy and Postpartum with and Without First-line Tuberculosis Drugs: Results from IMPAACT P1026s.Clinical pharmacokinetics · 2026Article
- Article
- Safety evaluation of pretomanid, an anti-tuberculosis drug, for the treatment of pregnant and lactating women.Antimicrobial agents and chemotherapy · 2026Article
- Life-threatening endobronchial clot in pregnancy with tuberculosis: Role of early bronchoscopy intervention.Indian journal of anaesthesia · 2026Article
- Tuberculosis in Pregnancy: An Updated Narrative Review.Diagnostics (Basel, Switzerland) · 2026Review
- Programmatic Results of Integrating Systematic TB Screening Across Diverse Outpatient Health System Entry Points in the Democratic Republic of the Congo.Tropical medicine and infectious disease · 2026Article
- Time to treatment initiation in pregnant women with tuberculosis in Cape Town, South Africa.medRxiv : the preprint server for health sciences · 2026Article
- Current and emerging therapies for pulmonary tuberculosis in adults.BMJ medicine · 2026Review
- Time to treatment initiation in pregnant women with tuberculosis in Cape Town, South Africa.PloS one · 2026Article
- Integrating tuberculosis control into maternal and newborn health services during pregnancy and postpartum is an urgent priority.PLOS global public health · 2026Article
- Tuberculosis Prevention in Pregnant Women Living with HIV: A Review of the Current Management Strategies and Guidance.Infection and drug resistance · 2026Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite known maternal, perinatal, and infant health risks of tuberculosis during pregnancy, global estimates of incidence remain scarce. Existing estimates are outdated, and do not include the postpartum period, HIV co-infection, age, or specific changes in risk, limiting our understanding of the true scale of disease in this understudied population.
methodsIn this rapid review and modelling analysis, we estimated the global tuberculosis incidence in pregnant and postpartum women using a population-based modelling approach. We searched MEDLINE and EMBASE, with no date or language limits, and included studies reporting tuberculosis incidence in pregnancy or postpartum with suitable comparison groups; we also used Feb 6, 2025, interim data from the ongoing ORCHID cohort. We combined WHO age and sex-stratified tuberculosis incidence data with country-specific population and fertility data to estimate baseline tuberculosis incidence, and applied systematic review-based risk ratios to account for elevated increased risk during pregnancy and postpartum. Uncertainty in all inputs was propagated using standard error propagation formulae and summarised as mean tuberculosis incidence rates and mean incidence rate ratios (IRRs), each reported with 95% quantile-based uncertainty intervals (UIs).
findingsWe identified 37 studies published between 1996 and 2020, of which three were of sufficient quality to provide data for HIV-negative women. One additional study (ORCHID; Odayar et al, unpublished) provided data for women living with HIV. Compared with non-pregnant women without HIV, tuberculosis IRRs were 1·34 (95% CI 1·17-1·54) during pregnancy and 1·91 (1·53-2·39) during postpartum among HIV-negative women. For women living with HIV, IRRs were 5·73 (95% CI 2·64-10·94) during pregnancy and 3·58 (0·85-9·63) postpartum. We estimated 239 500 pregnant women (95% UI 216 300-262 800) and 97 600 postpartum women (90 100-105 200) developed tuberculosis disease globally in 2023, with HIV contributing to 21·3% (19·8-22·8) and 10·6% (9·9-11·3) of cases, respectively. The WHO African region had the highest incidence (110 600 [95% UI 96 700-124 500] in pregnant women and 40 900 [36 300-45 400] in postpartum women), followed by the South-East Asia region (79 900 [64 100-95 700] in pregnant women and 35 900 [30 800-41 100] in postpartum women).
interpretationPregnant and postpartum women face substantial tuberculosis risk, yet remain under-represented in global estimates. Our findings underscore the need for improved surveillance and targeted interventions to reduce tuberculosis incidence in this group.
fundingUK Medical Research Council.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.