My pregnant wife needs to take TB medication, what are the risks?

• Standard TB medicines, Rifampicin, Ethambutol, Isoniazid and Pyrazinamide, have not been associated with harmful foetal effects. Though supplements may be useful for your baby during breastfeeding.
• Other medicines, such as Streptomycin, Capreomycin, Kanamycin, Tobramycin, Prothionamide and Ethionamide are not recommended for pregnant or breastfeeding women.
• Women who have drug resistant TB should inform their doctor if they are pregnant or breastfeeding, so that they can check the medicine being used is safe.

In extremely rare cases TB may cross the placenta, from the woman to the foetus. This is known as congenital TB and would only occur if the mother had TB bacteria in her blood, which would only occur in the acute phase of a primary infection, or if she had disseminated (miliary) TB and if the TB was going untreated.  If the mother was on anti-TB tablets then the risk of congenital disease is very small.

If TB is only diagnosed after the birth, the baby will need to be kept apart from the mother until she is assessed as non-infectious, or until the baby has been vaccinated against TB.