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Tuberculosis during pregnancy in the United States: Racial/ethnic disparities in pregnancy complications and in-hospital death

BACKGROUND: Despite decades of efforts to eliminate tuberculosis (TB) in the United States (US), TB still contributes to adverse ill health, especially among racial/ethnic minorities. According to the Centers for Disease Control and Prevention, in 2016, about 87% of the TB cases reported in the US w...

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Autores principales: Dennis, Erika M., Hao, Yun, Tamambang, Mabella, Roshan, Tasha N., Gatlin, Knubian J., Bghigh, Hanane, Ogunyemi, Oladimeji T., Diallo, Fatoumata, Spooner, Kiara K., Salemi, Jason L., Olaleye, Omonike A., Khan, Kashif Z., Aliyu, Muktar H., Salihu, Hamisu M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868821/
https://www.ncbi.nlm.nih.gov/pubmed/29579086
http://dx.doi.org/10.1371/journal.pone.0194836
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author Dennis, Erika M.
Hao, Yun
Tamambang, Mabella
Roshan, Tasha N.
Gatlin, Knubian J.
Bghigh, Hanane
Ogunyemi, Oladimeji T.
Diallo, Fatoumata
Spooner, Kiara K.
Salemi, Jason L.
Olaleye, Omonike A.
Khan, Kashif Z.
Aliyu, Muktar H.
Salihu, Hamisu M.
author_facet Dennis, Erika M.
Hao, Yun
Tamambang, Mabella
Roshan, Tasha N.
Gatlin, Knubian J.
Bghigh, Hanane
Ogunyemi, Oladimeji T.
Diallo, Fatoumata
Spooner, Kiara K.
Salemi, Jason L.
Olaleye, Omonike A.
Khan, Kashif Z.
Aliyu, Muktar H.
Salihu, Hamisu M.
author_sort Dennis, Erika M.
collection PubMed
description BACKGROUND: Despite decades of efforts to eliminate tuberculosis (TB) in the United States (US), TB still contributes to adverse ill health, especially among racial/ethnic minorities. According to the Centers for Disease Control and Prevention, in 2016, about 87% of the TB cases reported in the US were among racial and ethnic minorities. The objective of this study is to explore the risks for pregnancy complications and in-hospital death among mothers diagnosed with TB across racial/ethnic groups in the US. METHODS: This retrospective cohort study utilized National Inpatient Sample data for all inpatient hospital discharges in the US. We analyzed pregnancy-related hospitalizations and births in the US from January 1, 2002 through December 31, 2014 (n = 57,393,459). Multivariable logistic regression was applied to generate odds ratios for the association between TB status and the primary study outcomes (i.e., pregnancy complications and in-hospital death) across racial/ethnic categories. RESULTS: The prevalence of TB was 7.1 per 100,000 pregnancy-related hospitalizations. The overall prevalence of pregnancy complications was 80% greater among TB-infected mothers than their uninfected counterparts. Severe pre-eclampsia, eclampsia, placenta previa, post-partum hemorrhage, sepsis and anemia occurred with greater frequency among mothers with a TB diagnosis than those without TB, irrespective of race/ethnicity. The rate of in-hospital death among TB patients was 37 times greater among TB-infected than in non-TB infected mothers (468.8 per 100,000 versus 12.6 per 100,000). A 3-fold increased risk of in-hospital death was observed among black TB-negative mothers compared to their white counterparts. No racial/ethnic disparities in maternal morbidity or in-hospital death were found among mothers with TB disease. CONCLUSION: TB continues to be an important cause of morbidity and mortality among pregnant women in the US. Resources to address TB disease should also target pregnant women, especially racial/ethnic minorities who bear the greatest burden of the disease.
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spelling pubmed-58688212018-04-06 Tuberculosis during pregnancy in the United States: Racial/ethnic disparities in pregnancy complications and in-hospital death Dennis, Erika M. Hao, Yun Tamambang, Mabella Roshan, Tasha N. Gatlin, Knubian J. Bghigh, Hanane Ogunyemi, Oladimeji T. Diallo, Fatoumata Spooner, Kiara K. Salemi, Jason L. Olaleye, Omonike A. Khan, Kashif Z. Aliyu, Muktar H. Salihu, Hamisu M. PLoS One Research Article BACKGROUND: Despite decades of efforts to eliminate tuberculosis (TB) in the United States (US), TB still contributes to adverse ill health, especially among racial/ethnic minorities. According to the Centers for Disease Control and Prevention, in 2016, about 87% of the TB cases reported in the US were among racial and ethnic minorities. The objective of this study is to explore the risks for pregnancy complications and in-hospital death among mothers diagnosed with TB across racial/ethnic groups in the US. METHODS: This retrospective cohort study utilized National Inpatient Sample data for all inpatient hospital discharges in the US. We analyzed pregnancy-related hospitalizations and births in the US from January 1, 2002 through December 31, 2014 (n = 57,393,459). Multivariable logistic regression was applied to generate odds ratios for the association between TB status and the primary study outcomes (i.e., pregnancy complications and in-hospital death) across racial/ethnic categories. RESULTS: The prevalence of TB was 7.1 per 100,000 pregnancy-related hospitalizations. The overall prevalence of pregnancy complications was 80% greater among TB-infected mothers than their uninfected counterparts. Severe pre-eclampsia, eclampsia, placenta previa, post-partum hemorrhage, sepsis and anemia occurred with greater frequency among mothers with a TB diagnosis than those without TB, irrespective of race/ethnicity. The rate of in-hospital death among TB patients was 37 times greater among TB-infected than in non-TB infected mothers (468.8 per 100,000 versus 12.6 per 100,000). A 3-fold increased risk of in-hospital death was observed among black TB-negative mothers compared to their white counterparts. No racial/ethnic disparities in maternal morbidity or in-hospital death were found among mothers with TB disease. CONCLUSION: TB continues to be an important cause of morbidity and mortality among pregnant women in the US. Resources to address TB disease should also target pregnant women, especially racial/ethnic minorities who bear the greatest burden of the disease. Public Library of Science 2018-03-26 /pmc/articles/PMC5868821/ /pubmed/29579086 http://dx.doi.org/10.1371/journal.pone.0194836 Text en © 2018 Dennis et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Dennis, Erika M.
Hao, Yun
Tamambang, Mabella
Roshan, Tasha N.
Gatlin, Knubian J.
Bghigh, Hanane
Ogunyemi, Oladimeji T.
Diallo, Fatoumata
Spooner, Kiara K.
Salemi, Jason L.
Olaleye, Omonike A.
Khan, Kashif Z.
Aliyu, Muktar H.
Salihu, Hamisu M.
Tuberculosis during pregnancy in the United States: Racial/ethnic disparities in pregnancy complications and in-hospital death
title Tuberculosis during pregnancy in the United States: Racial/ethnic disparities in pregnancy complications and in-hospital death
title_full Tuberculosis during pregnancy in the United States: Racial/ethnic disparities in pregnancy complications and in-hospital death
title_fullStr Tuberculosis during pregnancy in the United States: Racial/ethnic disparities in pregnancy complications and in-hospital death
title_full_unstemmed Tuberculosis during pregnancy in the United States: Racial/ethnic disparities in pregnancy complications and in-hospital death
title_short Tuberculosis during pregnancy in the United States: Racial/ethnic disparities in pregnancy complications and in-hospital death
title_sort tuberculosis during pregnancy in the united states: racial/ethnic disparities in pregnancy complications and in-hospital death
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868821/
https://www.ncbi.nlm.nih.gov/pubmed/29579086
http://dx.doi.org/10.1371/journal.pone.0194836
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