tetano
Editor, Senior Moderator
J Glob Infect Dis
. 2021 Jan 29;13(1):20-26.
doi: 10.4103/jgid.jgid_157_20. eCollection Jan-Mar 2021.
Maternal and Perinatal Outcomes of Influenza in Pregnancy after Treatment with Oseltamivir
Kavitha Abraham[SUP] 1 [/SUP], Anuja Abraham[SUP] 1 [/SUP], Annie Regi[SUP] 1 [/SUP], Jessie Lionel[SUP] 1 [/SUP], Elsy Thomas[SUP] 1 [/SUP], Reeta Vijayaselvi[SUP] 1 [/SUP], L Jeyaseelan[SUP] 2 [/SUP], Asha Mary Abraham[SUP] 3 [/SUP], Sridhar Santhanam[SUP] 4 [/SUP], Kurian Anil Kuruvilla[SUP] 4 [/SUP], Mark C Steinhoff[SUP] 5 [/SUP]
Affiliations
Abstract
Context: Influenza infection in pregnancy causes 4%-8% case fatality and five times more perinatal mortality. Influenza is a major contributor to mortality in developing countries; however, the morbidity has largely been underestimated. Public health interventions for prevention are also lacking.
Aims: This study aimed to determine the seasonality of influenza in pregnant Indian women and to estimate the maternal and perinatal morbidity after treatment with oseltamivir.
Settings and design: This was a prospective observational cohort study, conducted in a tertiary hospital.
Subjects and methods: Pregnant women with ILI (influenza-like illness) were recruited into Cohort 1 (polymerase chain reaction [PCR] positive) and Cohort 2 (PCR negative). Gestational age-matched asymptomatic controls formed Cohort 3. Women in Cohort 1 received oseltamivir for 5 days. The incidence of small-for-gestational age (SGA) and preterm birth were the primary outcomes. Maternal and neonatal morbidity formed the secondary outcomes.
Statistical analysis: Unmatched (Cohort 1 and 2) and matched analysis (Cohort 1 and 3) were done. Student's t-test and Chi-square test were used to compare between variables.
Results: Year-round incidence of influenza was recorded. Severe illness was more in Cohort 1 compared to Cohort 2 (36.2% vs. 6.3%; P < 0.001). SGA was comparable in all the cohorts (13%). Preterm birth (7.8% vs. 3.3%; P < 0.08; relative risk-2.75) was considerably high in Cohort 1. Secondary maternal and neonatal outcomes were similar between the groups.
Conclusion: Influenza in pregnancy showed year-round incidence and increased maternal and neonatal morbidity despite treatment with oseltamivir. We suggest the need for newer interventions to curtail the illness in pregnancy.
Keywords: Influenza; influenza like illness; pregnancy; preterm birth; small for gestational age.
. 2021 Jan 29;13(1):20-26.
doi: 10.4103/jgid.jgid_157_20. eCollection Jan-Mar 2021.
Maternal and Perinatal Outcomes of Influenza in Pregnancy after Treatment with Oseltamivir
Kavitha Abraham[SUP] 1 [/SUP], Anuja Abraham[SUP] 1 [/SUP], Annie Regi[SUP] 1 [/SUP], Jessie Lionel[SUP] 1 [/SUP], Elsy Thomas[SUP] 1 [/SUP], Reeta Vijayaselvi[SUP] 1 [/SUP], L Jeyaseelan[SUP] 2 [/SUP], Asha Mary Abraham[SUP] 3 [/SUP], Sridhar Santhanam[SUP] 4 [/SUP], Kurian Anil Kuruvilla[SUP] 4 [/SUP], Mark C Steinhoff[SUP] 5 [/SUP]
Affiliations
- PMID: 33911448
- PMCID: PMC8054794
- DOI: 10.4103/jgid.jgid_157_20
Abstract
Context: Influenza infection in pregnancy causes 4%-8% case fatality and five times more perinatal mortality. Influenza is a major contributor to mortality in developing countries; however, the morbidity has largely been underestimated. Public health interventions for prevention are also lacking.
Aims: This study aimed to determine the seasonality of influenza in pregnant Indian women and to estimate the maternal and perinatal morbidity after treatment with oseltamivir.
Settings and design: This was a prospective observational cohort study, conducted in a tertiary hospital.
Subjects and methods: Pregnant women with ILI (influenza-like illness) were recruited into Cohort 1 (polymerase chain reaction [PCR] positive) and Cohort 2 (PCR negative). Gestational age-matched asymptomatic controls formed Cohort 3. Women in Cohort 1 received oseltamivir for 5 days. The incidence of small-for-gestational age (SGA) and preterm birth were the primary outcomes. Maternal and neonatal morbidity formed the secondary outcomes.
Statistical analysis: Unmatched (Cohort 1 and 2) and matched analysis (Cohort 1 and 3) were done. Student's t-test and Chi-square test were used to compare between variables.
Results: Year-round incidence of influenza was recorded. Severe illness was more in Cohort 1 compared to Cohort 2 (36.2% vs. 6.3%; P < 0.001). SGA was comparable in all the cohorts (13%). Preterm birth (7.8% vs. 3.3%; P < 0.08; relative risk-2.75) was considerably high in Cohort 1. Secondary maternal and neonatal outcomes were similar between the groups.
Conclusion: Influenza in pregnancy showed year-round incidence and increased maternal and neonatal morbidity despite treatment with oseltamivir. We suggest the need for newer interventions to curtail the illness in pregnancy.
Keywords: Influenza; influenza like illness; pregnancy; preterm birth; small for gestational age.