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BackgroundDespite decades of efforts to eliminate tuberculosis (TB) in the United States (US), TB still contributes to adverse ill health, especially among racial/ethnic minorities. According to the Centers for Disease Control and Prevention, in 2016, about 87% of the TB cases reported in the US were among racial and ethnic minorities. The objective of this study is to explore the risks for pregnancy complications and in-hospital death among mothers diagnosed with TB across racial/ethnic groups in the US.MethodsThis retrospective cohort study utilized National Inpatient Sample data for all inpatient hospital discharges in the US. We analyzed pregnancy-related hospitalizations and births in the US from January 1, 2002 through December 31, 2014 (n = 57,393,459). Multivariable logistic regression was applied to generate odds ratios for the association between TB status and the primary study outcomes (i.e., pregnancy complications and in-hospital death) across racial/ethnic categories.ResultsThe prevalence of TB was 7.1 per 100,000 pregnancy-related hospitalizations. The overall prevalence of pregnancy complications was 80% greater among TB-infected mothers than their uninfected counterparts. Severe pre-eclampsia, eclampsia, placenta previa, post-partum hemorrhage, sepsis and anemia occurred with greater frequency among mothers with a TB diagnosis than those without TB, irrespective of race/ethnicity. The rate of in-hospital death among TB patients was 37 times greater among TB-infected than in non-TB infected mothers (468.8 per 100,000 versus 12.6 per 100,000). A 3-fold increased risk of in-hospital death was observed among black TB-negative mothers compared to their white counterparts. No racial/ethnic disparities in maternal morbidity or in-hospital death were found among mothers with TB disease.ConclusionTB continues to be an important cause of morbidity and mortality among pregnant women in the US. Resources to address TB disease should also target pregnant women, especially racial/ethnic minorities who bear the greatest burden of the disease.

Designing inter-regional and inter-provincial responsibility-sharing mechanisms for climate change mitigation requires the knowledge of carbon distributions. This study is the first to use a two-sector (i.e., productive and household sectors) inequality decomposition approach to examine the regional, provincial, and national inequalities of per capita CO2 emissions (CPC) in China, as well as their determinants. We show that the CPC inequality index in China increased from 1.1364 in 2000 to 2.3688 in 2017, with the productive sector accounting for 91.42% of this expansion and households responsible for the rest. The production-side per capita output level, energy efficiency, energy structure, and industrial structure explain 69.01%, 12.81%, 5.57%, and 4.03% of these inequalities, respectively. Further, the household per capita energy consumption and energy structure explain only 8.12% and 0.46%, respectively. Therefore, future responsibility-sharing mechanisms for climate mitigation need to be formulated taking mainly the productive sector into account.