Examining family planning and adverse pregnancy outcomes for women with active tuberculosis disease: a systematic review
Abstract
Objectives: (1) Summarise and evaluate the current evidence of tuberculosis (TB)-associated pregnancy outcomes, (2) evaluate the state of the science of family planning during TB treatment and (3) provide recommendations to move forward to improve care and outcomes during TB disease.
Design: Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
Data sources: PubMed, Embase, CINAHL, Cochrane, Web of Science and Scopus were searched from September 2009 to November 2021.
Eligibility criteria: Studies were included if they assessed pregnant women with active TB, drug-resistant TB (DR-TB) or TB/HIV coinfection and examined pregnancy, maternal, fetal/birth and TB or TB/HIV coinfection outcomes. Studies were also included if they examined family planning services among women initiating TB treatment.
Data extraction and synthesis: Two independent reviewers extracted data using PRISMA guidelines and conducted quality assessment using the Joanna-Briggs Institute Critical Appraisal Tools. The level of evidence was reported using the Johns Hopkins Evidence-Based Practice guidelines.
Results: 69 studies were included in this review. Case reports, case series, case controls, cohort studies, secondary data analyses and a service delivery improvement project conducted in 26 countries made up the totality of the evidence. Most studies reported pregnancy complications for mothers (anaemia, postpartum haemorrhage, deaths) and…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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