tetano
Editor, Senior Moderator
Ann Intern Med
. 2021 Dec 28.
doi: 10.7326/M21-3668. Online ahead of print.
Characteristics and Outcomes of Hospitalized Pregnant Women With Influenza, 2010 to 2019 : A Repeated Cross-Sectional Study
Rachel Holstein[SUP] 1 [/SUP], Fatimah S Dawood[SUP] 1 [/SUP], Alissa O'Halloran[SUP] 1 [/SUP], Charisse Cummings[SUP] 1 [/SUP], Dawud Ujamaa[SUP] 2 [/SUP], Pam Daily Kirley[SUP] 3 [/SUP], Kimberly Yousey-Hindes[SUP] 4 [/SUP], Emily Fawcett[SUP] 5 [/SUP], Maya L Monroe[SUP] 6 [/SUP], Sue Kim[SUP] 7 [/SUP], Ruth Lynfield[SUP] 8 [/SUP], Chelsea McMullen[SUP] 9 [/SUP], Alison Muse[SUP] 10 [/SUP], Nancy M Bennett[SUP] 11 [/SUP], Laurie M Billing[SUP] 12 [/SUP], Melissa Sutton[SUP] 13 [/SUP], Ann Thomas[SUP] 13 [/SUP], H Keipp Talbot[SUP] 14 [/SUP], William Schaffner[SUP] 14 [/SUP], Ilene Risk[SUP] 15 [/SUP], Carrie Reed[SUP] 1 [/SUP], Shikha Garg[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Pregnant women may be at increased risk for severe influenza-associated outcomes.
Objective: To describe characteristics and outcomes of hospitalized pregnant women with influenza.
Design: Repeated cross-sectional study.
Setting: The population-based U.S. Influenza Hospitalization Surveillance Network during the 2010-2011 through 2018-2019 influenza seasons.
Patients: Pregnant women (aged 15 to 44 years) hospitalized with laboratory-confirmed influenza identified through provider-initiated or facility-based testing practices.
Measurements: Clinical characteristics, interventions, and in-hospital maternal and fetal outcomes were obtained through medical chart abstraction. Multivariable logistic regression was used to evaluate the association between influenza A subtype and severe maternal influenza-associated outcomes, including intensive care unit (ICU) admission, mechanical ventilation, extracorporeal membrane oxygenation, or in-hospital death.
Results: Of 9652 women aged 15 to 44 years and hospitalized with influenza, 2690 (27.9%) were pregnant. Among the 2690 pregnant women, the median age was 28 years, 62% were in their third trimester, and 42% had at least 1 underlying condition. Overall, 32% were vaccinated against influenza and 88% received antiviral treatment. Five percent required ICU admission, 2% required mechanical ventilation, and 0.3% (n = 8) died. Pregnant women with influenza A H1N1 were more likely to have severe outcomes than those with influenza A H3N2 (adjusted risk ratio, 1.9 [95% CI, 1.3 to 2.8]). Most women (71%) were still pregnant at hospital discharge. Among 754 women who were no longer pregnant at discharge, 96% had a pregnancy resulting in live birth, and 3% experienced fetal loss.
Limitation: Maternal and fetal outcomes that occurred after hospital discharge were not captured.
Conclusion: Over 9 influenza seasons, one third of reproductive-aged women hospitalized with influenza were pregnant. Influenza A H1N1 was associated with more severe maternal outcomes. Pregnant women remain a high-priority target group for vaccination.
Primary funding source: Centers for Disease Control and Prevention.
. 2021 Dec 28.
doi: 10.7326/M21-3668. Online ahead of print.
Characteristics and Outcomes of Hospitalized Pregnant Women With Influenza, 2010 to 2019 : A Repeated Cross-Sectional Study
Rachel Holstein[SUP] 1 [/SUP], Fatimah S Dawood[SUP] 1 [/SUP], Alissa O'Halloran[SUP] 1 [/SUP], Charisse Cummings[SUP] 1 [/SUP], Dawud Ujamaa[SUP] 2 [/SUP], Pam Daily Kirley[SUP] 3 [/SUP], Kimberly Yousey-Hindes[SUP] 4 [/SUP], Emily Fawcett[SUP] 5 [/SUP], Maya L Monroe[SUP] 6 [/SUP], Sue Kim[SUP] 7 [/SUP], Ruth Lynfield[SUP] 8 [/SUP], Chelsea McMullen[SUP] 9 [/SUP], Alison Muse[SUP] 10 [/SUP], Nancy M Bennett[SUP] 11 [/SUP], Laurie M Billing[SUP] 12 [/SUP], Melissa Sutton[SUP] 13 [/SUP], Ann Thomas[SUP] 13 [/SUP], H Keipp Talbot[SUP] 14 [/SUP], William Schaffner[SUP] 14 [/SUP], Ilene Risk[SUP] 15 [/SUP], Carrie Reed[SUP] 1 [/SUP], Shikha Garg[SUP] 1 [/SUP]
Affiliations
- PMID: 34958603
- DOI: 10.7326/M21-3668
Abstract
Background: Pregnant women may be at increased risk for severe influenza-associated outcomes.
Objective: To describe characteristics and outcomes of hospitalized pregnant women with influenza.
Design: Repeated cross-sectional study.
Setting: The population-based U.S. Influenza Hospitalization Surveillance Network during the 2010-2011 through 2018-2019 influenza seasons.
Patients: Pregnant women (aged 15 to 44 years) hospitalized with laboratory-confirmed influenza identified through provider-initiated or facility-based testing practices.
Measurements: Clinical characteristics, interventions, and in-hospital maternal and fetal outcomes were obtained through medical chart abstraction. Multivariable logistic regression was used to evaluate the association between influenza A subtype and severe maternal influenza-associated outcomes, including intensive care unit (ICU) admission, mechanical ventilation, extracorporeal membrane oxygenation, or in-hospital death.
Results: Of 9652 women aged 15 to 44 years and hospitalized with influenza, 2690 (27.9%) were pregnant. Among the 2690 pregnant women, the median age was 28 years, 62% were in their third trimester, and 42% had at least 1 underlying condition. Overall, 32% were vaccinated against influenza and 88% received antiviral treatment. Five percent required ICU admission, 2% required mechanical ventilation, and 0.3% (n = 8) died. Pregnant women with influenza A H1N1 were more likely to have severe outcomes than those with influenza A H3N2 (adjusted risk ratio, 1.9 [95% CI, 1.3 to 2.8]). Most women (71%) were still pregnant at hospital discharge. Among 754 women who were no longer pregnant at discharge, 96% had a pregnancy resulting in live birth, and 3% experienced fetal loss.
Limitation: Maternal and fetal outcomes that occurred after hospital discharge were not captured.
Conclusion: Over 9 influenza seasons, one third of reproductive-aged women hospitalized with influenza were pregnant. Influenza A H1N1 was associated with more severe maternal outcomes. Pregnant women remain a high-priority target group for vaccination.
Primary funding source: Centers for Disease Control and Prevention.