Epidemiology and clinical outcomes of hospitalizations for acute respiratory or febrile illness and laboratory-confirmed influenza among pregnant women during six influenza seasons, 2010-2016

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J Infect Dis. 2019 Dec 26. pii: jiz670. doi: 10.1093/infdis/jiz670. [Epub ahead of print] Epidemiology and clinical outcomes of hospitalizations for acute respiratory or febrile illness and laboratory-confirmed influenza among pregnant women during six influenza seasons, 2010-2016.

Dawood FS¹, Garg S¹, Fink RV², Russell ML³, Regan AK⁴, Katz MA^5,6,7, Booth S³, Chung H⁸, Klein NP⁹, Kwong JC^8,10,11, Levy A¹², Naleway A¹³, Riesel D⁵, Thompson MG¹, Wyant BE², Fell DB^8,14,15.
Author information

1 Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA USA. 2 Abt Associates, Cambridge, MA, USA. 3 Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 4 School of Public Health, Curtin University, Perth, Western Australia, Australia. 5 Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel. 6 School of Public Health, Medical School for International Health, Ben Gurion University, Beer-Sheva, Israel. 7 University of Michigan School of Public Health, Ann Arbor, MI, USA. 8 ICES, Toronto, Ontario, Canada. 9 Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California, Oakland, CA, USA. 10 Public Health Ontario, Toronto, Ontario, Canada. 11 Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada. 12 PathWest Laboratory Medicine WA, Perth, WA, Australia. 13 Center for Health Research, Kaiser Permanente Northwest, Portland, OR USA. 14 University of Ottawa, Ottawa, Ontario, Canada. 15 Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.

Abstract

BACKGROUND:

Pregnant women are at increased risk of seasonal influenza hospitalizations, but data about the epidemiology of severe influenza among pregnant women remain largely limited to pandemics.
METHODS:

To describe the epidemiology of hospitalizations for acute respiratory infection or febrile illness (ARFI) and influenza-associated ARFI among pregnant women, administrative and electronic health record data were analyzed from retrospective cohorts of pregnant women hospitalized with ARFI who had testing for influenza viruses by RT-PCR in Australia, Canada, Israel and the United States during 2010-2016.
RESULTS:

Of 18,048 ARFI-coded hospitalizations, 1,064 (6%) included RT-PCR testing for influenza viruses, of which 614 (58%) were influenza-positive. Of 614 influenza-positive ARFI hospitalizations, 35% were in women with low socioeconomic status, 20% with underlying conditions, and 67% in their third trimesters. The median length of influenza-positive hospitalizations was 2 days (IQR 1-4), 18% (95% confidence interval (CI) 15-21%) resulted in delivery, 10% (95% CI 8-12%) included a pneumonia diagnosis, 5% (95% CI 3-6%) required intensive care, 2% (95% CI 1-3%) included a sepsis diagnosis, and <1% (95% CI 0-1%) resulted in respiratory failure.
CONCLUSIONS:

Our findings characterize seasonal influenza hospitalizations among pregnant women and can inform assessments of the public health and economic impact of seasonal influenza on pregnant women.
Published by Oxford University Press for the Infectious Diseases Society of America 2019. This work is written by (a) US Government employee(s) and is in the public domain in the US.


KEYWORDS:

Hospitalization; Influenza; Pregnant

PMID: 31875916 DOI: 10.1093/infdis/jiz670