Tuberculosis, fertility and pregnancy: the clinical and experimental aspects
Kayukova S.I., Ulyumdzhieva V.A., Kulakova E.V., Nikonenko B.V., Fortygina Yu.A., Shchelykalina S.P., Karpina N.L.
The epidemiological situation for tuberculosis in the Russian Federation has improved over the last decade. However, fertility potential and unplanned pregnancy in women in detection and treatment of tuberculosis (TB) of the respiratory organs raise concern.
Objective: To explore the relationship between unplanned pregnancy and the course of TB of the respiratory organs in women and assess the influence of tuberculosis infection on fertility of BALB/c female mice to develop a clinical and experimental concept for a possibility of getting pregnant with favorable perinatal outcomes.
Materials and methods: Observational cross-sectional study was carried out at the Central Research Institute of Tuberculosis. The study included 164 patients, who were divided into 2 groups. Group 1 included 82 pregnant women, who had TB of the respiratory organs. Group 2 included 82 non-pregnant women, who had TB of the repiratory organs. The experimental research was conducted using 40 BALB/c female mice. The mice were divided into 2 groups. Group 1 included 20 pregnant mice infected with Mtb. Group 2 included 20 pregnant mice, but not infected with Mtb.
Results: Active TB disease suppresses the reproductive potential in BALB/c female mice. In women, who have TB of the respiratory organs, unfavorable social and fertility factors increase the risk of unplanned pregnancy by 3.5 times, that aggravates the course of tuberculosis compared with non-pregnant patients. Late relapses occur by 2.5 times more often, exudative pleurisy and bronchial tuberculosis by 1.7 times, late detection of cavernous pulmonary tuberculosis by 5.5 times. The reverse negative impact of TB of the respiratory organs on the course of pregnancy, delivery and the postpartum period was not detected.
Conclusion: The scientifically based interdisciplinary approach to pregnancy management, taking into account unfavorable social and fertility factors in women with TB of the respiratory organs, makes it possible to achieve high efficacy of anti-tuberculosis therapy, to reduce the frequency of obstetric complications, and to have favorable perinatal outcomes.
Authors' contributions: Kayukova S.I., Ulyumdzhieva V.A., Kulakova E.V., Nikonenko B.V., Fortygina Yu.A., Shchelykalina S.P., Karpina N.L. – development of the study design, obtaining data for analysis, review of publications on the topic of the article, analysis of the obtained data, article writing.
Conflicts of interest: The authors confirm that they have no conflict of interest to declare.
Funding: The study was conducted within the framework of the fundamental theme “Tuberculosis and respiratory diseases – modern multimodal diagnosis and rehabilitation in comorbid conditions” at the Center for the diagnosis and rehabilitation of respiratory diseases of the Central Research Institute of Tuberculosis, UN FURE-2022-0013. Reg. No.122041200022-2.
Ethical Approval: The study was approved by Research Ethics Committee of the Central Research Institute of Tuberculosis (protocol No. 11, 2020). The experimental procedures were approved by Animal Care Ethics Committee of the Central Research Institute of Tuberculosis (protocol IACUC No. 8).
Patient Consent for Publication: The patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Kayukova S.I., Ulyumdzhieva V.A., Kulakova E.V., Nikonenko B.V., Fortygina Yu.A., Shchelykalina S.P., Karpina N.L. Tuberculosis, fertility and pregnancy: the clinical and experimental aspects.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (6): 140-148 (in Russian)
https://dx.doi.org/10.18565/aig.2025.91
Keywords
tuberculosis
fertility
pregnancy
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Received 03.04.2025
Accepted 27.05.2025
About the Authors
Svetlana I. Kayukova, Dr. Med. Sci., obstetrician-gynecologist at the Center for diagnostics and rehabilitation of respiratory diseases, Central Research Institute of Tuberculosis; Professor at the Department of Phthisiology, N.I. Pirogov Russian National Research Medical University, Ministry of Health od Russia, 117513, Russia, Moscow, Ostrovityanov str., 1, +7(915)396-85-34, kajukovalnp@gmail.com, https://orcid.org/0000-0002-5233-3515Valentina A. Ulyumdzhieva, PhD student, Central Research Institute of Tuberculosis, 107564, Russia, Moscow, Yauzskaya alley, 2, +7(937)196-92-22, amulek@bk.ru,
https://orcid.org/0009-0005-8037-249Х
Elena V. Kulakova, PhD, Senior Researcher at the Prof. B.V. Leonov Department of IVF, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(985)769-53-57, e_kulakova@oparina4.ru,
https://orcid.org/0000-0002-4433-4163
Boris V. Nikonenko, Leading Researcher at the Department of Immunology, Central Research Institute of Tuberculosis, 107564, Russia, Moscow, Yauzskaya alley, 2, +7(985)951-95-78, boris.nikonenko52@gmail.com, https://orcid.org/0000-0003-3205-8197
Yulia A. Fortygina, PhD student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(950)727-07-45, yu_fortygina@oparina4.ru, https://orcid.org/0000-0002-1251-0505
Svetlana P. Shchelykalina, PhD, Associate Professor at the Department of Medical Cybernetics and Computer Science named after S.A. Gasparyan MBF, Pirogov Russian National Research Medical University, Ministry of Health of Russia, 117513, Russia, Moscow, Ostrovityanov str., 1, +7(905)771-46-48, svetlanath@inbox.ru,
https://orcid.org/0000-0003-3292-8949
Natalya L. Karpina, Deputy Director for Science, Central Research Institute of Tuberculosis, 107564, Russia, Moscow, Yauzskaya alley, 2, +7(916)097-36-96,
natalya-karpina@rambler.ru, https://orcid.org/0000-0001-7800-8158
Corresponding author: Svetlana I. Kayukova, kajukovalnp@gmail.com
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