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Severity of influenza and non-influenza acute respiratory illness among pregnant women, 2010-12

tetano

Editor, Senior Moderator
Am J Obstet Gynecol. 2014 Aug 8. pii: S0002-9378(14)00816-3. doi: 10.1016/j.ajog.2014.08.004. [Epub ahead of print]
Severity of influenza and non-influenza acute respiratory illness among pregnant women, 2010-12.
Sokolow LZ1, Naleway AL2, Li DK3, Shifflett P4, Reynolds S5, Henninger ML2, Ferber JR6, Odouli R6, Irving SA2, Thompson MG5; The Pregnancy and Influenza Project Workgroup.
Author information
Abstract
OBJECTIVE:

To identify characteristics of influenza illness contrasted with non-influenza acute respiratory illnesses (ARI) in pregnant women.
STUDY DESIGN:

ARI among pregnant women was identified through daily surveillance during two influenza seasons (2010-12). Within 8 days of illness onset, nasopharyngeal swabs were collected, and an interview was conducted for symptoms and other characteristics. A follow-up telephone interview was conducted 1-2 weeks later, and medical records were extracted. Severity of illness was evaluated by self-assessment of 12 illness symptoms, subjective ratings of overall impairment, highest reported temperature, illness duration, and medical utilization.
RESULTS:

Of 292 pregnant women with ARI, 100 tested positive for influenza viruses. Women with influenza illnesses reported higher symptom severity than those with non-influenza ARI (median score: 18 vs. 16 out of 36; p<.05) and were more likely to report severe subjective feverishness (18% vs. 5%; p<.001), myalgia (28% vs 14%; p<.005), cough (46% vs 30%; p<.01), and chills (25% vs. 13%; p<.01). More influenza illnesses were associated with fever >38.9oC (20% vs. 5%; p<.001) and higher subjective impairment (mean score 5.9 vs. 4.8; p<.001). Differences in overall symptom severity, fever, cough, chills, early healthcare-seeking behavior, and impairment remained significant in multivariate models after adjusting for study site, season, age, vaccination status, and number of days since illness onset.
CONCLUSION:

Influenza had a greater negative impact on pregnant women than non-influenza ARIs, as indicated by symptom severity and greater likelihood of elevated temperature. These results highlight the importance of preventing and treating influenza illnesses in pregnant women.

Copyright ? 2014 Mosby, Inc. All rights reserved.
KEYWORDS:

acute respiratory illness; illness severity; influenza; influenza vaccine; pregnancy

PMID:
25111585
[PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25111585
 
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