بررسی عفونت سل در زنان باردار و اثرات آن بر نوزادان

نوع مقاله : مروری

نویسندگان

1 دانشجوی دکترای تخصصی گروه میکروب شناسی و ویروس شناسی، دانشکده علوم پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

2 دانشیار گروه میکروب و ویروس شناسی، مرکز تحقیقات مقاومت های میکروبی، دانشکده علوم پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: باکتری مایکوباکتریوم توبرکلوزیس، عامل بیماری سل، به عنوان یک تهدید فراگیر جوامع شناخته می شود. بر اساس گزارش سازمان جهانی بهداشت در سال 2014، حدود 3/3 میلیون زن باردار عفونت فعال سل داشته اند. این میزان بالای ابتلاء، چالش بزرگی برای بهداشت جوامع محسوب می شود. پیشگیری و کنترل سل در زنان باردار به دلیل وضعیت خاص سیستم ایمنی، نیازمند تدابیر خاص است. لذا مطالعه مروری حاضر با هدف بررسی اثرات عفونت سل مادرزادی بر روی جنین و نوزادان انجام شد.
روش کار: در این مطالعه مروری مقالات مربوط به عفونت سل در مادران باردار و نوزادان از پایگاه های اطلاعاتی علمی همچون EBSCO، Chemical abstract، PubMed، Scopus، Google Scholar، SID، MedLib، ISI، ISC، Iran Medex و بدون محدودیت زمانی جستجو شد و بر اساس وجود سل تأیید شده در بیماران و وجود سل مادرزادی منطبق با معیار کانت ول، این مقالات وارد مطالعه شدند. همچنین تجزیه و تحلیل داده ها به صورت کیفی انجام شد.
یافته‌ها: در این مطالعه مهم‌ترین عوارض عفونت سل مادرزادی در نوزادان متولد شده از زنان باردار مبتلا به عفونت سل در 32 مطالعه انجام شده که دارای معیار ورود به مطالعه بودند، مورد بررسی قرار گرفتند. با ارزیابی انجام شده، مشخص شد که زنان باردار به عفونت سل حساس هستند و انتقال عفونت سل در نوزادان با مادران آلوده بیشتر از سایر نوزادان با مادران غیر آلوده است. نتایج مطالعه نشان داد که عفونت سل اثر منفی بر روی رشد و نمو جنین دارد و باعث تولد نوزادان کم وزن و نارس می‌شود. همچنین مرگ و میر نوزادان به دلیل عفونت سل با افزایش همراه بود.
نتیجه‌گیری: تشخیص به موقع و انجام درمان مناسب می‌تواند باعث کاهش عوارض عفونت سل مادرزادی به خصوص موارد مرگ و میر نوزادان و تولد نوزادان نارس یا کم وزن شود. در این زمینه افزایش آگاهی در سیستم مراقبت‌های بهداشتی و بیماران، تدوین برنامه های پیشگیری کننده و انجام آزمون‌های تشخیصی سریع و اجرای یک رژیم درمانی منسجم برای بیماری سل در زنان باردار به منظور پیشگیری و درمان اهمیت ویژه ای دارد.

کلیدواژه‌ها

عنوان مقاله [English]

Evaluation of tuberculosis infection in pregnant women and its effects on newborns: an Overview

نویسندگان [English]

  • Bagher Moradi 1
  • Zahra Meshkat 2
1 Ph.D Student, Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Associate professor, Department of Microbiology and Virology, Antimicrobial Resistance Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Mycobacterium tuberculosis, the cause of tuberculosis, is known as communities' inclusive threat. According to the report of World Health Organization (WHO) in 2014, about 3.3 million pregnant women have been infected with tuberculosis. This high rate of TB infection is huge challenge for social health. Prevention and control of TB in the pregnant woman, because of the special status of immune system, requires specific management. So, this study was performed with aim to determine the effects of congenital tuberculosis on the fetus and newborns..
Methods: In this review study, the articles related to TB infection in pregnant women and newborns were extracted from scientific databases such as EBSCO, Chemical abstract, PubMed, Scopus, Google Scholar, SID, MedLib, Iran Medex, ISI, ISC, with no time limitation. These articles were entered to the study according to the confirmed tuberculosis in the patients and the congenital tuberculosis based on Cantwell’s criteria. Also, data analysis was performed qualitatively.
Results: In this study, the most important congenital complications in the newborns of pregnant women with TB in 32 articles which had the inclusion criteria were examined. The evaluation showed that pregnant women are susceptible to tuberculosis and TB transmission in children born from TB-infected pregnant women was higher than non-infected pregnant women. It has been confirmed that tuberculosis has an adverse effect on fetal growth and causes the birth of low weight and premature neonates. Also, neonatal mortality due to TB was associated with an increase.
Conclusion: Early diagnosis and proper treatment can reduce the complications of congenital TB, especially neonatal mortality and the birth of low weight and premature neonates. In this regard, increasing the awareness within health care system and patient, developing the preventive plans and performing rapid diagnostic tests and the implementation of a comprehensive treatment regimen for TB in pregnant women for prevention and treatment is of great importance.

کلیدواژه‌ها [English]

  • Congenital
  • neonate
  • pregnancy
  • Mycobacterium tuberculosis
  • Tuberculosis

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مجله زنان، مامایی و نازایی ایران
دوره 18، شماره 178 - شماره پیاپی 178
هفته چهارم دی ماه 1394
دی 1394
صفحه 21-36

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