{ "abstract": "Data on the safety of tuberculosis preventive treatment (TPT) during pregnancy particularly from routine care settings in high tuberculosis (TB) burden countries remain limited. We evaluated the association between TPT exposure during pregnancy and adverse pregnancy outcomes among pregnant women living with HIV (WLHIV) in Uganda. We conducted a retrospective cohort study using routinely collected data from five public urban primary health facilities in Kampala, Uganda. We included pregnant women living with HIV on antiretroviral therapy (ART) between 2016 and 2022. The primary outcome was a composite of adverse pregnancy outcomes: miscarriage, stillbirth, low birth weight, neonatal complications, or maternal/neonatal death. A secondary composite outcome excluded neonatal and maternal death. There was no preterm delivery documented in this sample. The primary exposure was 6-month isoniazid preventive therapy (IPT) during pregnancy. We applied inverse probability of treatment weighting (IPTW) using propensity scores from logistic regression to adjust for confounding. Missing data on covariates and outcome were addressed using multiple imputation. Analysis was performed using R software v.4.3.3. We analyzed data from 521 pregnant WLHIV, the median age was 28 years (interquartile range 24–31), 44% of whom received IPT during pregnancy. Overall, 10.0% experienced an adverse pregnancy outcome. No significant differences were observed between IPT-exposed and unexposed groups for the primary (10.3% vs. 9.6%; p = 0.81) or secondary (10.3% vs. 8.5%; p = 0.50) composite outcomes. IPTW-adjusted analysis showed no significant association between IPT exposure and adverse pregnancy outcomes (weighted OR: 1.06; 95% CI: 0.68–1.63; p = 0.81). Sensitivity and subgroup analyses yielded consistent findings. Exposure to 6-month isoniazid TPT during pregnancy was not statistically associated with adverse pregnancy outcomes among women on ART in routine care settings. Strengthened pharmacovigilance and systematic clinical reporting are essential to ensure maternal and neonatal safety as TPT coverage expands in high TB/HIV burden settings.", "abstract_shown": true, "affiliations": [ "Infectious Diseases Institute, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda", "Global Health Institute, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium", "School of Medicine, University of St Andrews, St Andrews, Scotland, United Kingdom", "National Tuberculosis and Leprosy Program, Uganda Ministry of Health, Kampala, Uganda", "Department of Disease Control, LSHTM, London, United Kingdom", "VIBRANIUM RESOURCES Foundation, Addis Ababa, Ethiopia", "Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America", "Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden" ], "article_type": "Research Article", "arxiv": null, "author_total": 8, "authors": [ { "affs": [ 0 ], "name": "Joseph Musaazi" }, { "affs": [ 1 ], "name": "Christine Sekaggya-Wiltshire" }, { "affs": [ 2 ], "name": "Stella Zawedde-Muyanja" }, { "affs": [ 3 ], "name": "Proscovia M. Namuwenge" }, { "affs": [ 4 ], "name": "M. Sanni Ali" }, { "affs": [ 5 ], "name": "Yukari C. Manabe" }, { "affs": [ 6 ], "name": "Barbara Castelnuovo" }, { "affs": [ 7 ], "name": "Nele Brusselaers" } ], "bibtex": "https://research.draconitic.com/paper/a9hzjxpe9pwg9.bib", "cited_by": 0, "doi": "10.1371/journal.pgph.0005829", "fulltext_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005829", "id": "a9hzjxpe9pwg9", "issns": [ "2767-3375" ], "landing_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005829", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2725|Tuberculosis Research and Epidemiology" ], [ "plos", "/Biology and life sciences/Developmental biology/Neonates" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/RNA viruses/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Physiology/Physiological parameters/Body weight" ], [ "plos", "/Biology and life sciences/Physiology/Physiological parameters/Body weight/Birth weight" ], [ "plos", "/Medicine and health sciences/Epidemiology/Medical risk factors" ], [ "plos", "/Medicine and health sciences/Medical conditions/Infectious diseases/Bacterial diseases/Tuberculosis" ], [ "plos", "/Medicine and health sciences/Medical conditions/Tropical diseases/Tuberculosis" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Medicine and health sciences/Women's health/Maternal health/Pregnancy" ], [ "plos", "/Medicine and health sciences/Women's health/Obstetrics and gynecology/Pregnancy" ], [ "plos", "/People and places/Geographical locations/Africa/Uganda" ] ], "openalex": "W7214393953", "pdf_url": "https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0005829&type=printable", "pmcid": null, "pmid": null, "published": "2026-09-25", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/a9hzjxpe9pwg9.ris", "sources": [ { "first_seen": "2026-10-30T12:17:43Z", "native_id": "10.1371/journal.pgph.0005829", "source": "plos", "url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005829" } ], "subjects": [ { "field": "biology", "origin": "plos:microbiology", "subfield": "microbiology" }, { "field": "medicine", "origin": "plos:physiology", "subfield": "physiology" }, { "field": "medicine", "origin": "plos:women's health", "subfield": "reproductive-child" } ], "title": "Isoniazid monotherapy for tuberculosis prevention during pregnancy and adverse outcomes in women living with HIV in Uganda: A propensity score–weighted analysis of routine care data", "title_text": "Isoniazid monotherapy for tuberculosis prevention during pregnancy and adverse outcomes in women living with HIV in Uganda: A propensity score–weighted analysis of routine care data", "type": "peer-reviewed", "updated_at": "2026-10-30T12:17:43Z", "url": "https://research.draconitic.com/paper/a9hzjxpe9pwg9", "venue": "PLOS Global Public Health", "versions": [] }