Untreated Prior Pulmonary Tuberculosis Adversely Affects Pregnancy Outcomes in Infertile Women Undergoing in vitro Fertilization and Embryo Transfer: A Large Retrospective Cohort Study

• 作者: GAI Xiao Yan CHI Hong Bin ZENG Lin CAO Wen Li CHEN Li Xue ZHANG Chen LU Ming NING Lan Ding CHANG Chun ZHANG Wei Xia LIU Ping LI Rong SUN Yong Chang QIAO Jie
• 来源期刊: 生物医学与环境科学（英文版）
• 年，卷（期）: 2021,（2）
• 所属期刊栏目: Special Column: Reproductive Health
• 页码范围: 130-138,中插15-中插18
• 页数: 1页
• 语种: 英文
• DOI: 10.3967/bes2021.019

摘要

Objective Prior pulmonary tuberculosis (PTB) on chest X-ray (CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer (IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET. Method We conducted a retrospective cohort study of 14,254 infertile patients who had received IVF-ET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth, clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups. Results The untreated PTB group had significantly lower clinical pregnancy (31.7％ vs. 38.1％) and live birth (23.8％ vs. 30.6％) rates than the non-PTB group (both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio (OR), 0.80; 95％ confidence interval (CI), 0.66–0.98; P = 0.028] in all patients and for increased miscarriage (OR, 4.19; 95％ CI, 1.69–10.39; P = 0.002) and decreased live birth (OR, 0.45; 95％ CI, 0.24–0.83; P = 0.011) rates in patients with unexplained infertility. Conclusions Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.