How Does TB Affect Pregnancy and Breastfeeding?
HIV-infected pregnant women who are suspected of having TB should be treated without delay. TB treatment regimens for HIV-infected pregnant women should include rifamycin.
Although the routine use of PZA during pregnancy is not recommended in the United States, the benefits of a TB treatment regimen that includes PZA for HIV-infected pregnant women outweigh the undetermined potential risks to the fetus.
The following tuberculosis medications are not recommended in pregnant women:
Women who are being treated for drug-resistant TB should receive counseling concerning the risk to the fetus because of the known and unknown risks of second-line tuberculosis drugs.
Breastfeeding should not be discouraged for women being treated with the first-line tuberculosis drugs, because the concentrations of these drugs in breast milk are too small to produce toxicity in the nursing newborn. For the same reason, drugs in breast milk are not an effective treatment for latent or active tuberculosis in a nursing infant. Breastfeeding women taking INH should also take pyridoxine (vitamin B6) supplementation.