Tuberculosis Treatment During Pregnancy

Medically Reviewed by Jennifer Robinson, MD on August 31, 2022
3 min read

When you’re pregnant, your doctor will give you a number of routine tests to check for any health issues that might pose problems for you or your baby. One thing they may check you for early on is tuberculosis (TB). It’s a contagious bacterial disease that usually affects your lungs.

If you don’t get the right treatment for TB, it can be dangerous for you and your baby. You can die of it. So your doctor will want you to start treatment right away.

You can have TB and not know it. That’s called latent TB. But if you have active TB, you’ll have symptoms like coughing for weeks, weight loss, bloody phlegm, and night sweats.

The active form of the disease is more serious. But both active and latent TB can cause harm to your baby. They may be more likely to:

  • Weigh less than a baby born to a healthy mother
  • Be born with TB. This is rare.
  • Catch TB from you after birth, if your disease is active and you aren’t being treated

You may worry that taking medicine for tuberculosis may harm your unborn child. It’s much worse to leave it untreated. TB drugs you take do reach your baby. But they haven’t been shown to cause harm in unborn babies.

Some TB drugs can lead to birth defects or other problems in a growing baby. But your doctor won’t prescribe those drugs if you’re pregnant or thinking about getting pregnant.

The medicine you get will depend on what kind of TB you have.

Latent TB. If you have no symptoms but tests show that you have the disease, you’ll likely take a drug called isoniazid. You may need to take it every day for 9 months, or just twice a week during that time. You’ll have to take vitamin B6 supplements at the same time. You can also take a combination of isoniazid and rifampin for 3 months.

Active TB. Usually, you’ll get three drugs at first: isoniazid, rifampin, and ethambutol. You’ll probably need to take all three every day for 2 months. For the rest of your pregnancy, it’s likely that you’ll take only isoniazid and rifampin, either daily or twice a week.

HIV and TB. If you also have HIV, your doctor probably will give you the same drugs to treat both diseases that they would give someone who’s not pregnant. Talk to your doctor so you understand the safest options for you and your baby.

If the drugs you try first don’t work against your TB, you may have a drug-resistant form of the disease.

Your doctor may recommend that you switch to so-called second-line drugs. Some of them aren’t safe to take during pregnancy. They can cause birth defects and other problems. If you need second-line treatment, you may need to avoid or delay getting pregnant. Ask your doctor for counseling.

After your baby is born, you should be able to breastfeed them safely, even if you’re still taking first-line drugs for TB. If you’re on isoniazid, keep taking vitamin B6 while you nurse your newborn.

Although some of the drug will pass into your breast milk, the amount is too little to cause any harm.