Maternal and perinatal mortality and morbidity associated with tuberculosis during pregnancy and the postpartum period: a systematic review and meta‐analysis
Bibliographic record
Abstract
Background There is a dearth of data on the clinical features and outcomes of active tuberculosis ( TB ) in pregnancy. Studies have shown varied results and the relationship between TB and adverse pregnancy outcomes remains unclear. Objectives We conducted a systematic review and meta‐analysis to evaluate pregnancy outcomes associated with TB . Search strategy Major databases were searched from inception until December 2015 without restrictions using the terms: ‘ TB ’, ‘pregnancy’, ‘maternal morbidity’, ‘mortality’ and ‘perinatal morbidity’, ‘mortality’. Selection criteria We included studies that compared the outcomes of pregnant women with and without active TB. Data collection and analysis We computed odds ratios for maternal and perinatal complications, and pooled them using a random effects model. We assessed for heterogeneity using chi‐squared tests and evaluated its magnitude using the I 2 statistic. We used the Newcastle–Ottawa scale for quality assessment. Main results Thirteen studies, including 3384 pregnancies with active TB and 119 448 without TB were included. Compared with pregnant women without TB , pregnant women with active TB was associated with increased odds of maternal morbidity [odds ratio ( OR ) 2.8, 95% CI 1.7–4.6; I 2 = 60.3%], anaemia ( OR 3.9, 95% CI 2.2–6.7; I 2 = 29.8%), caesarean delivery ( OR 2.1, 95% CI 1.2–3.8; I 2 = 61.1%), preterm birth ( OR 1.7, 95% CI 1.2–2.4; I 2 = 66.5%), low birth weight ( OR 1.7, 95% CI 1.2–2.4; I 2 = 53.7%), birth asphyxia ( OR 4.6, 95% CI 2.4–8.6; I 2 = 46.3), and perinatal death ( OR 4.2, 95% CI 1.5–11.8; I 2 = 57.2%). Author's conclusion Active TB in pregnancy is associated with adverse maternal and fetal outcomes. Early diagnosis of TB is important to prevent significant maternal and perinatal complications. Tweetable abstract Active tuberculosis in pregnancy is associated with adverse maternal and perinatal outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.033 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.038 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".