Wouter J Meijer1, Aleid G A van Noortwijk2, Hein W Bruinse1, Annemarie M J Wensing3. 1. Perinatal Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands. 2. Department of Obstetrics and Gynecology, Ikazia Hospital, Rotterdam, the Netherlands. 3. Department of Virology, Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Abstract
BACKGROUND: Influenza virus infection is very common and a significant cause of morbidity and mortality in specific populations like pregnant women. Following the 2009 pandemic, several reports on the effects of influenza virus infection on maternal health and pregnancy outcome have been published. Also the safety and efficacy of antiviral treatment and vaccination of pregnant women have been studied. In this review, we have analyzed and summarized these data. OBJECTIVE: To provide information on the influence of influenza virus infection during pregnancy on maternal health and pregnancy outcome and on the effect of treatment and vaccination. DATA SOURCES: We have searched Medline, Embase and the Cochrane Library. We used influenza, influenz*, pregnancy and pregnan* as search terms. STUDY SELECTION: In total, 294 reports were reviewed and judged according to the STROBE guidelines or CONSORT statement. In all, 100 studies, published between 1961 and 2015, were included. RESULTS: Compared to the general population, pregnant women are more often hospitalized and admitted to an intensive care unit due to influenza virus infection. For hospitalized patients, increased rates of preterm birth and fetal/neonatal death are reported. Early treatment with oseltamivir is associated with a reduced risk of severe disease. Vaccination of pregnant women is safe and reduces maternal and neonatal morbidity. CONCLUSIONS: There is level 2b evidence that maternal health and pregnancy outcome can be severely affected by influenza virus infection. Antiviral treatment may diminish these effects and vaccination protects pregnant women and neonates from infection (level of evidence 2b and 1b, respectively).
BACKGROUND:Influenza virus infection is very common and a significant cause of morbidity and mortality in specific populations like pregnant women. Following the 2009 pandemic, several reports on the effects of influenza virus infection on maternal health and pregnancy outcome have been published. Also the safety and efficacy of antiviral treatment and vaccination of pregnant women have been studied. In this review, we have analyzed and summarized these data. OBJECTIVE: To provide information on the influence of influenza virus infection during pregnancy on maternal health and pregnancy outcome and on the effect of treatment and vaccination. DATA SOURCES: We have searched Medline, Embase and the Cochrane Library. We used influenza, influenz*, pregnancy and pregnan* as search terms. STUDY SELECTION: In total, 294 reports were reviewed and judged according to the STROBE guidelines or CONSORT statement. In all, 100 studies, published between 1961 and 2015, were included. RESULTS: Compared to the general population, pregnant women are more often hospitalized and admitted to an intensive care unit due to influenza virus infection. For hospitalized patients, increased rates of preterm birth and fetal/neonatal death are reported. Early treatment with oseltamivir is associated with a reduced risk of severe disease. Vaccination of pregnant women is safe and reduces maternal and neonatal morbidity. CONCLUSIONS: There is level 2b evidence that maternal health and pregnancy outcome can be severely affected by influenza virus infection. Antiviral treatment may diminish these effects and vaccination protects pregnant women and neonates from infection (level of evidence 2b and 1b, respectively).
Authors: Deshayne B Fell; Zulfiqar A Bhutta; Jennifer A Hutcheon; Ruth A Karron; Marian Knight; Michael S Kramer; Arnold S Monto; Geeta K Swamy; Justin R Ortiz; David A Savitz Journal: Vaccine Date: 2017-03-24 Impact factor: 3.641
Authors: Sarah N Cross; Julie A Potter; Paulomi Aldo; Ja Young Kwon; Mary Pitruzzello; Mancy Tong; Seth Guller; Carla V Rothlin; Gil Mor; Vikki M Abrahams Journal: J Immunol Date: 2017-09-15 Impact factor: 5.422
Authors: Carmen S Arriola; Nancy Vasconez; Mark Thompson; Sara Mirza; Ann C Moen; Joseph Bresee; Ivy Talavera; Alba María Ropero Journal: Vaccine Date: 2016-01-15 Impact factor: 3.641
Authors: Eliza C Miller; Marisa Gallo; Erin R Kulick; Alexander M Friedman; Mitchell S V Elkind; Amelia K Boehme Journal: Stroke Date: 2018-05 Impact factor: 7.914
Authors: Deshayne B Fell; Eduardo Azziz-Baumgartner; Michael G Baker; Maneesh Batra; Julien Beauté; Philippe Beutels; Niranjan Bhat; Zulfiqar A Bhutta; Cheryl Cohen; Bremen De Mucio; Bradford D Gessner; Michael G Gravett; Mark A Katz; Marian Knight; Vernon J Lee; Mark Loeb; Johannes M Luteijn; Helen Marshall; Harish Nair; Kevin Pottie; Rehana A Salam; David A Savitz; Suzanne J Serruya; Becky Skidmore; Justin R Ortiz Journal: Vaccine Date: 2017-09-01 Impact factor: 3.641