The effect of antenatal TB disease on pregnancy outcomes and neonatal health outcomes in the Western Cape Province, South Africa
1
School of Public Health, University of Cape Town, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A485
ABSTRACT
BACKGROUND:
Tuberculosis (TB) during pregnancy is a significant public health concern, linked to adverse maternal and neonatal outcomes. Despite South Africa’s high TB burden, there is limited population-based evidence on the impact of TB during pregnancy on health outcomes for mothers and infants.
OBJECTIVE:
This study aims to assess the impact of TB disease during pregnancy on pregnancy and neonatal outcomes in the Western Cape (WC) Province, South Africa, using a population-wide dataset.
METHODS:
We will conduct a retrospective cohort study using de-identified, individual-level data from the Provincial Health Data Centre (PHDC), integrating routine health information across provincial public healthcare facilities. The study population includes all women documented as pregnant between January 2019 and December 2024 comparing those concurrently diagnosed with TB disease during that same pregnancy and those without TB disease during their pregnancy. Primary outcomes include miscarriage, stillbirth, ectopic pregnancy, elective termination of pregnancy and maternal death, while secondary outcomes focus on neonatal complications: neonatal death, neonatal TB, low birth weight and prematurity. Descriptive statistics will summarize baseline characteristics by TB exposure group. Categorical variables will be compared using chi-squared tests, while continuous variables will be analysed with t-tests or Mann–Whitney U-tests. Multivariable logistic regression will estimate adjusted odds ratios for adverse outcomes, accounting for potential confounding and effect modification. Composite outcomes of both adverse pregnancy and neonatal outcomes will also be assessed. Sensitivity analyses will address rare outcomes and competing risks, and sub-analyses will stratify by gestational age at first antenatal visit to account for left truncation.
CONCLUSIONS:
This study will provide critical evidence on the impact of TB during pregnancy on pregnancy and neonatal health outcomes in a high TB-burden setting. Findings may inform clinical management and health policies to improve care for pregnant women affected by TB in the WC Province.
Tuberculosis (TB) during pregnancy is a significant public health concern, linked to adverse maternal and neonatal outcomes. Despite South Africa’s high TB burden, there is limited population-based evidence on the impact of TB during pregnancy on health outcomes for mothers and infants.
OBJECTIVE:
This study aims to assess the impact of TB disease during pregnancy on pregnancy and neonatal outcomes in the Western Cape (WC) Province, South Africa, using a population-wide dataset.
METHODS:
We will conduct a retrospective cohort study using de-identified, individual-level data from the Provincial Health Data Centre (PHDC), integrating routine health information across provincial public healthcare facilities. The study population includes all women documented as pregnant between January 2019 and December 2024 comparing those concurrently diagnosed with TB disease during that same pregnancy and those without TB disease during their pregnancy. Primary outcomes include miscarriage, stillbirth, ectopic pregnancy, elective termination of pregnancy and maternal death, while secondary outcomes focus on neonatal complications: neonatal death, neonatal TB, low birth weight and prematurity. Descriptive statistics will summarize baseline characteristics by TB exposure group. Categorical variables will be compared using chi-squared tests, while continuous variables will be analysed with t-tests or Mann–Whitney U-tests. Multivariable logistic regression will estimate adjusted odds ratios for adverse outcomes, accounting for potential confounding and effect modification. Composite outcomes of both adverse pregnancy and neonatal outcomes will also be assessed. Sensitivity analyses will address rare outcomes and competing risks, and sub-analyses will stratify by gestational age at first antenatal visit to account for left truncation.
CONCLUSIONS:
This study will provide critical evidence on the impact of TB during pregnancy on pregnancy and neonatal health outcomes in a high TB-burden setting. Findings may inform clinical management and health policies to improve care for pregnant women affected by TB in the WC Province.
| eISSN: | 2654-1459 |
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