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J Infect Dis. 2019 Jan 23. doi: 10.1093/infdis/jiz035. [Epub ahead of print]
Influenza associated outcomes among pregnant, post-partum, and non-pregnant women of reproductive age.
Prasad N1, Huang QS1, Wood T1, Aminisani N1,2, McArthur C3, Baker MG4, Seeds R1, Thompson MG5, Widdowson MA5, Newbern EC1.
Author information
Abstract
Background:
Pregnant women are prioritised for seasonal influenza vaccination however, evidence on influenza risk during pregnancy used to inform these policies is limited.
Methods:
Individual-level administrative datasets and active surveillance data were joined to estimate influenza-associated hospitalisation and outpatient visit rates by pregnancy, post-partum and trimester status.
Results:
During 2012-2015, 46 (17.7%) of 260 influenza-confirmed acute respiratory hospitalisations and 13 (4.4%) of 294 influenza-confirmed outpatient visits were among pregnant and post-partum women. Pregnant and post-partum women experienced higher rates of influenza hospitalisation compared with non-pregnant women overall (Rate Ratio [RR] 3.4; 95% Confidence Interval [CI] 2.5-4.7) and by trimester (1st: 2.5; 95%CI 1.2-5.4; 2nd: 3.9; 95%CI 2.4-6.3; 3rd: 4.8; 95%CI 3.0-7.7; post-partum: 0.7; 95%CI 3.0-7.7). Influenza A viruses were associated with increased risk (A(H1N1)pdm09: 5.3; 95%CI 3.2-8.7 and A(H3N2): 3.0; 95%CI 1.8-5.0), but not influenza B (1.8; 95%CI 0.7-4.6). Influenza hospitalisation rates in pregnancy were significantly higher for Māori women (RR 3.2; 95% CI 1.3-8.4) compared with women of European/Other ethnicity. Similar risks for influenza-confirmed outpatient visits were not observed.
Conclusion:
Seasonal influenza poses higher risks of hospitalisation on pregnant women in all trimesters when compared with non-pregnant women. Hospitalisation rates vary by influenza type and ethnicity among pregnant women.
PMID: 30690449 DOI: 10.1093/infdis/jiz035
Influenza associated outcomes among pregnant, post-partum, and non-pregnant women of reproductive age.
Prasad N1, Huang QS1, Wood T1, Aminisani N1,2, McArthur C3, Baker MG4, Seeds R1, Thompson MG5, Widdowson MA5, Newbern EC1.
Author information
Abstract
Background:
Pregnant women are prioritised for seasonal influenza vaccination however, evidence on influenza risk during pregnancy used to inform these policies is limited.
Methods:
Individual-level administrative datasets and active surveillance data were joined to estimate influenza-associated hospitalisation and outpatient visit rates by pregnancy, post-partum and trimester status.
Results:
During 2012-2015, 46 (17.7%) of 260 influenza-confirmed acute respiratory hospitalisations and 13 (4.4%) of 294 influenza-confirmed outpatient visits were among pregnant and post-partum women. Pregnant and post-partum women experienced higher rates of influenza hospitalisation compared with non-pregnant women overall (Rate Ratio [RR] 3.4; 95% Confidence Interval [CI] 2.5-4.7) and by trimester (1st: 2.5; 95%CI 1.2-5.4; 2nd: 3.9; 95%CI 2.4-6.3; 3rd: 4.8; 95%CI 3.0-7.7; post-partum: 0.7; 95%CI 3.0-7.7). Influenza A viruses were associated with increased risk (A(H1N1)pdm09: 5.3; 95%CI 3.2-8.7 and A(H3N2): 3.0; 95%CI 1.8-5.0), but not influenza B (1.8; 95%CI 0.7-4.6). Influenza hospitalisation rates in pregnancy were significantly higher for Māori women (RR 3.2; 95% CI 1.3-8.4) compared with women of European/Other ethnicity. Similar risks for influenza-confirmed outpatient visits were not observed.
Conclusion:
Seasonal influenza poses higher risks of hospitalisation on pregnant women in all trimesters when compared with non-pregnant women. Hospitalisation rates vary by influenza type and ethnicity among pregnant women.
PMID: 30690449 DOI: 10.1093/infdis/jiz035