Bibliographic Info
GuidelineWHO recommendations on antenatal care for a positive pregnancy experience
Year of Publication2016
Issuing InstitutionWHO
Recommendation
Status
Updated
Context specific recommendation
Only in specific contexts
In settings where the tuberculosis (TB) prevalence in the general population is 100/100 000 population or higher, systematic screening for active TB should be considered for pregnant women as part of antenatal care.
Notes and Remarks
- 1.This recommendation has been adapted and integrated from the 2013 WHO publication Systematic screening for active tuberculosis: principles and recommendations, where it was considered a conditional recommendation based on very low-quality evidence
- 2.Systematic screening is defined as the systematic identification of people with suspected active TB in a predetermined target group, using tests, examinations or other procedures that can be applied rapidly. Options for initial screening include screening for symptoms (either for cough lasting longer than two weeks, or any symptoms compatible with TB, including a cough of any duration, haemoptysis, weight loss, fever or night sweats) or screening with chest radiography. The use of chest radiography in pregnant women poses no significant risk but the national guidelines for the use of radiography during pregnancy should be followed
- 3.Before screening is initiated, high-quality TB diagnosis, treatment, care, management and support should be in place, and there should be the capacity to scale these up further to match the anticipated rise in case detection that may occur as a result of screening.
- 4.The panel responsible for making this recommendation noted that it may not be possible to implement it in resource-constrained settings 5 TB increases the risk of preterm birth, perinatal death and other pregnancy complications. Initiating TB treatment early is associated with better maternal and infant outcomes than late initiation.
- 6.To better understand the local burden of TB in pregnancy, health systems may benefit from capturing pregnancy status in registers that track TB screening and treatment.
- 7.Further information and considerations related to this recommendation can be found in the 2013 WHO recommendations, available at: http://www.who.int/tb/tbscreening/en/