{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:21:02Z","timestamp":1787167262358,"version":"build-2736575974"},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Tuberculosis (TB) in pregnancies conceived via in\u00a0vitro fertilization (IVF) presents unique diagnostic and management challenges, especially in TB-endemic regions. This systematic review synthesizes evidence on maternal and neonatal TB outcomes after IVF. We conducted a systematic review of case reports, case series, and cohort studies, following PRISMA 2020 guidelines. Databases searched included PubMed, Scopus, Embase, and Google Scholar. Quality assessment was performed using Murad\u2019s framework and the Newcastle-Ottawa Scale. Seventy-three IVF pregnancies complicated by maternal TB were analyzed. Median maternal age was 32 years; 63.0% had no prior TB history. TB was diagnosed during pregnancy (56.2%) or postpartum (38.4%). Miliary TB (38.4%) and genital TB (27.4%) were most common; central nervous system (CNS) TB occurred in 13.7%. Microbiological confirmation was achieved in 38.4%. Anti-TB therapy was administered to 79.5%; 8.2% had drug-resistant TB. Neonatal TB manifestations included congenital TB (39.7%), miliary TB (34.2%), and CNS TB (15.1%). Of 55 live births, 28 infants survived, 12 died neonatally, and outcomes were missing for 15; there were 18 pregnancy losses. Most mothers recovered, some had residual deficits, and three deaths occurred. Seven cohort studies from China reported earlier TB onset in IVF pregnancies (11\u201319 weeks\u2019 gestation), higher incidence of miliary and CNS TB, and poor fetal outcomes, including &gt;80% pregnancy terminations or losses, in comparison with natural conceptions. TB after IVF is often undiagnosed before conception and carries high fetal risks. Routine TB screening before IVF is essential in endemic areas. Early diagnosis and maternal\u2013neonatal management can improve outcomes.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0410","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T15:21:41Z","timestamp":1762874501000},"page":"10-14","source":"Crossref","is-referenced-by-count":2,"title":["Tuberculosis Following In\u00a0Vitro Fertilization: A Systematic Review of Maternal and Newborn Outcomes"],"prefix":"10.4269","volume":"114","author":[{"given":"Ravindra Kumar","family":"Garg","sequence":"first","affiliation":[{"name":"Department of Neurology, Era's Lucknow Medical College & Hospital, Lucknow, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, King George\u2019s Medical University, Lucknow, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshaya Anand","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Surgery, King George\u2019s Medical University, Lucknow, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Singhal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raza Abbas","family":"Mahdi","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"Tuberculosis.","year":"2025"},{"key":"b2","series-title":"Clin Perinatol","first-page":"107","article-title":"TB: An old disease but a new threat to the mother, newborns, and neonate","volume":"24","author":"Starke","year":"1997"},{"key":"b3","series-title":"J Perinatol","first-page":"389","article-title":"Congenital and perinatal TB: Discussion of difficult issues in diagnosis and management","volume":"18","author":"Hageman","year":"1998"},{"key":"b4","series-title":"Paediatr Int Child Health","first-page":"216","article-title":"Congenital TB: Case report and review of the literature","volume":"38","author":"Chang","year":"2018"},{"key":"b5","series-title":"Pediatr Pulmonol","first-page":"1215","article-title":"Analysis of 170 cases of congenital TB reported in the literature between 1946 and 2009","volume":"46","author":"Peng","year":"2011"},{"key":"b6","article-title":"TB Following in\u00a0Vitro Fertilization: A Systematic Review of Case Reports, Case Series, and Cohort Studies.","author":"Garg"},{"key":"b7","series-title":"N Engl J Med","first-page":"1051","article-title":"Brief report: Congenital TB","volume":"330","author":"Cantwell","year":"1994"},{"key":"b8","series-title":"BMJ Evid Based Med","first-page":"60","article-title":"Methodological quality and synthesis of case series and case reports","volume":"23","author":"Murad","year":"2018"},{"key":"b9","series-title":"Am J Obstet Gynecol","first-page":"36","article-title":"Coronavirus disease 2019 during pregnancy: A systematic review of reported cases","volume":"223","author":"Della Gatta","year":"2020"},{"key":"b10","series-title":"Best Pract Res Clin Obstet Gynaecol","first-page":"34","article-title":"TB in pregnancy","volume":"85","author":"Hui","year":"2022"},{"key":"b11","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1331","article-title":"Notes from the field: Undiagnosed tuberculosis during pregnancy resulting in a neonatal death - United States, 2021","volume":"72","author":"Miele","year":"2023"},{"key":"b12","series-title":"Drug Discov Ther","first-page":"80","article-title":"TB in pregnancy and assisted reproductive technology","volume":"18","author":"Cao","year":"2024"},{"key":"b13","series-title":"Indian J Tuberc","first-page":"195","article-title":"TB and its clinical consequences on women's health","volume":"71","author":"Sundaram","year":"2024"},{"key":"b14","series-title":"Open Respir Arch","first-page":"100354","article-title":"Miliary TB during pregnancy after in\u00a0vitro fertilization","volume":"6","author":"Jim\u00e9nez-Fuentes","year":"2024"},{"key":"b15","series-title":"Front Med (Lausanne)","first-page":"1626519","article-title":"The impact of IGRA positivity in untreated inactive pulmonary tuberculosis on IVF-ET outcomes in infertile women: An ambispective cohort study","volume":"12","author":"Gai","year":"2025"},{"key":"b16","series-title":"Front Public Health","first-page":"1021998","article-title":"Association of in\u00a0vitro fertilization with maternal and perinatal outcomes among pregnant women with active tuberculosis: A retrospective hospital-based cohort study","volume":"10","author":"Xia","year":"2022"},{"key":"b17","series-title":"Am J Trop Med Hyg","first-page":"170","article-title":"Clinical features and outcomes of tuberculosis after in\u00a0vitro fertilization-embryo transfer compared with natural pregnancy: A retrospective study","volume":"113","author":"Wen","year":"2025"},{"key":"b18","year":"2022"},{"key":"b19","article-title":"Tuberculosis Clinical Care and Treatment During Pregnancy.","year":"2025"},{"key":"b1","article-title":"Tuberculosis.","year":"2025"},{"key":"b2","series-title":"Clin Perinatol","first-page":"107","article-title":"TB: An old disease but a new threat to the mother, newborns, and neonate","volume":"24","author":"Starke","year":"1997"},{"key":"b3","series-title":"J Perinatol","first-page":"389","article-title":"Congenital and perinatal TB: Discussion of difficult issues in diagnosis and management","volume":"18","author":"Hageman","year":"1998"},{"key":"b4","series-title":"Paediatr Int Child Health","first-page":"216","article-title":"Congenital TB: Case report and review of the literature","volume":"38","author":"Chang","year":"2018"},{"key":"b5","series-title":"Pediatr Pulmonol","first-page":"1215","article-title":"Analysis of 170 cases of congenital TB reported in the literature between 1946 and 2009","volume":"46","author":"Peng","year":"2011"},{"key":"b6","article-title":"TB Following in\u00a0Vitro Fertilization: A Systematic Review of Case Reports, Case Series, and Cohort Studies.","author":"Garg"},{"key":"b7","series-title":"N Engl J Med","first-page":"1051","article-title":"Brief report: Congenital TB","volume":"330","author":"Cantwell","year":"1994"},{"key":"b8","series-title":"BMJ Evid Based Med","first-page":"60","article-title":"Methodological quality and synthesis of case series and case reports","volume":"23","author":"Murad","year":"2018"},{"key":"b9","series-title":"Am J Obstet Gynecol","first-page":"36","article-title":"Coronavirus disease 2019 during pregnancy: A systematic review of reported cases","volume":"223","author":"Della Gatta","year":"2020"},{"key":"b10","series-title":"Best Pract Res Clin Obstet Gynaecol","first-page":"34","article-title":"TB in pregnancy","volume":"85","author":"Hui","year":"2022"},{"key":"b11","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1331","article-title":"Notes from the field: Undiagnosed tuberculosis during pregnancy resulting in a neonatal death - 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