Michael W Varner1, Madeline Murguia Rice, Brenna Anderson, Jorge E Tolosa, Jeanne Sheffield, Catherine Y Spong, George Saade, Alan M Peaceman, Judette M Louis, Ronald J Wapner, Alan T N Tita, Yoram Sorokin, Sean C Blackwell, Mona Prasad, John M Thorp, Amber Naresh, J Peter Van Dorsten. 1. From the Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah; Brown University, Providence, Rhode Island; Oregon Health & Science University, Portland, Oregon; the University of Texas Southwestern Medical Center, Dallas, Texas; the University of Texas Medical Branch, Galveston, Texas; Northwestern University, Chicago, Illinois; Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio; Columbia University, New York, New York; the University of Alabama at Birmingham, Birmingham, Alabama; Wayne State University, Detroit, Michigan; the University of Texas Health Science Center at Houston, Houston, Texas; The Ohio State University, Columbus, Ohio; the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the University of Pittsburgh, Pittsburgh, Pennsylvania; the Medical University of South Carolina, Charleston, South Carolina; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Abstract
OBJECTIVE: To estimate characteristics and outcomes of pregnant and immediately postpartum women hospitalized with influenza-like illness during the 2009-2010 influenza pandemic and the factors associated with more severe illness. METHODS: An observational cohort in 28 hospitals of pregnant and postpartum (within 2 weeks of delivery) women hospitalized with influenza-like illness. Influenza-like illness was defined as clinical suspicion of influenza and either meeting the Centers for Disease Control and Prevention definition of influenza-like illness (fever 100.0°F or higher, cough, sore throat) or a positive influenza test. RESULTS: Of 356 women meeting eligibility criteria, 35 (9.8%) were admitted to the intensive care unit (ICU) and four (1.1%) died. Two hundred eighteen women (61.2%) were in the third trimester and 10 (2.8%) were postpartum. More than half (55.3%) were admitted in October and 25.0% in November with rapidly decreasing numbers thereafter. Antiviral therapy was administered to 10.1% of the women before hospitalization and to 88.5% during hospitalization. Factors associated with an increased likelihood of ICU admission included cigarette smoking (29.4% compared with 13.4%; odds ratio [OR] 2.77, 95% confidence interval [CI] 1.19-6.45) and chronic hypertension (17.1% compared with 3.1%; OR 6.86, 95% CI 2.19-21.51). Antiviral treatment within 2 days of symptom onset decreased the likelihood of ICU admission (31.4% compared with 56.6%, OR 0.36, 95% CI 0.16-0.77). CONCLUSION: Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency. LEVEL OF EVIDENCE: II.
OBJECTIVE: To estimate characteristics and outcomes of pregnant and immediately postpartum women hospitalized with influenza-like illness during the 2009-2010 influenza pandemic and the factors associated with more severe illness. METHODS: An observational cohort in 28 hospitals of pregnant and postpartum (within 2 weeks of delivery) women hospitalized with influenza-like illness. Influenza-like illness was defined as clinical suspicion of influenza and either meeting the Centers for Disease Control and Prevention definition of influenza-like illness (fever 100.0°F or higher, cough, sore throat) or a positive influenza test. RESULTS: Of 356 women meeting eligibility criteria, 35 (9.8%) were admitted to the intensive care unit (ICU) and four (1.1%) died. Two hundred eighteen women (61.2%) were in the third trimester and 10 (2.8%) were postpartum. More than half (55.3%) were admitted in October and 25.0% in November with rapidly decreasing numbers thereafter. Antiviral therapy was administered to 10.1% of the women before hospitalization and to 88.5% during hospitalization. Factors associated with an increased likelihood of ICU admission included cigarette smoking (29.4% compared with 13.4%; odds ratio [OR] 2.77, 95% confidence interval [CI] 1.19-6.45) and chronic hypertension (17.1% compared with 3.1%; OR 6.86, 95% CI 2.19-21.51). Antiviral treatment within 2 days of symptom onset decreased the likelihood of ICU admission (31.4% compared with 56.6%, OR 0.36, 95% CI 0.16-0.77). CONCLUSION: Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency. LEVEL OF EVIDENCE: II.
Authors: Anne C B Perdigão; Fernanda M C Araújo; Maria E L Melo; Daniele R Q Lemos; Luciano P Cavalcanti; Izabel L C Ramalho; Lia C Araújo; Deborah M Sousa; Marilda M Siqueira; Maria I F Guedes Journal: Influenza Other Respir Viruses Date: 2015-11 Impact factor: 4.380
Authors: Matthew J Memoli; Hillery Harvey; David M Morens; Jeffery K Taubenberger Journal: Influenza Other Respir Viruses Date: 2012-11-21 Impact factor: 4.380