Fatimah S Dawood1, Shikha Garg1, Rebecca V Fink2, Margaret L Russell3, Annette K Regan4, Mark A Katz5,6,7, Stephanie Booth3, Hannah Chung8, Nicola P Klein9, Jeffrey C Kwong8,10,11, Avram Levy12, Allison Naleway13, Dan Riesel5, Mark G Thompson1, Brandy E Wyant2, Deshayne B Fell8,14,15. 1. Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 2. Abt Associates, Cambridge, Massachusetts, USA. 3. Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 4. School of Public Health, Curtin University, Perth, Western Australia, Australia. 5. Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel. 6. School of Public Health, Medical School for International Health, Ben Gurion University, Beer-Sheva, Israel. 7. University of Michigan School of Public Health, Ann Arbor, Michigan, USA. 8. ICES, Toronto, Ontario, Canada. 9. Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California, Oakland, California, USA. 10. Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada. 11. Public Health Ontario, Toronto, Ontario, Canada. 12. PathWest Laboratory Medicine WA, Perth, Western Australia, Australia. 13. Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA. 14. University of Ottawa, Ottawa, Ontario, Canada. 15. Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Abstract
BACKGROUND: Pregnant women are at increased risk of seasonal influenza hospitalizations, but data about the epidemiology of severe influenza among pregnant women remain largely limited to pandemics. METHODS: To describe the epidemiology of hospitalizations for acute respiratory infection or febrile illness (ARFI) and influenza-associated ARFI among pregnant women, administrative and electronic health record data were analyzed from retrospective cohorts of pregnant women hospitalized with ARFI who had testing for influenza viruses by reverse-transcription polymerase chain reaction (RT-PCR) in Australia, Canada, Israel, and the United States during 2010-2016. RESULTS: Of 18 048 ARFI-coded hospitalizations, 1064 (6%) included RT-PCR testing for influenza viruses, 614 (58%) of which were influenza positive. Of 614 influenza-positive ARFI hospitalizations, 35% were in women with low socioeconomic status, 20% with underlying conditions, and 67% in their third trimesters. The median length of influenza-positive hospitalizations was 2 days (interquartile range, 1-4), 18% (95% confidence interval [CI], 15%-21%) resulted in delivery, 10% (95% CI, 8%-12%) included a pneumonia diagnosis, 5% (95% CI, 3%-6%) required intensive care, 2% (95% CI, 1%-3%) included a sepsis diagnosis, and <1% (95% CI, 0%-1%) resulted in respiratory failure. CONCLUSIONS: Our findings characterize seasonal influenza hospitalizations among pregnant women and can inform assessments of the public health and economic impact of seasonal influenza on pregnant women. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
BACKGROUND: Pregnant women are at increased risk of seasonal influenza hospitalizations, but data about the epidemiology of severe influenza among pregnant women remain largely limited to pandemics. METHODS: To describe the epidemiology of hospitalizations for acute respiratory infection or febrile illness (ARFI) and influenza-associated ARFI among pregnant women, administrative and electronic health record data were analyzed from retrospective cohorts of pregnant women hospitalized with ARFI who had testing for influenza viruses by reverse-transcription polymerase chain reaction (RT-PCR) in Australia, Canada, Israel, and the United States during 2010-2016. RESULTS: Of 18 048 ARFI-coded hospitalizations, 1064 (6%) included RT-PCR testing for influenza viruses, 614 (58%) of which were influenza positive. Of 614 influenza-positive ARFI hospitalizations, 35% were in women with low socioeconomic status, 20% with underlying conditions, and 67% in their third trimesters. The median length of influenza-positive hospitalizations was 2 days (interquartile range, 1-4), 18% (95% confidence interval [CI], 15%-21%) resulted in delivery, 10% (95% CI, 8%-12%) included a pneumonia diagnosis, 5% (95% CI, 3%-6%) required intensive care, 2% (95% CI, 1%-3%) included a sepsis diagnosis, and <1% (95% CI, 0%-1%) resulted in respiratory failure. CONCLUSIONS: Our findings characterize seasonal influenza hospitalizations among pregnant women and can inform assessments of the public health and economic impact of seasonal influenza on pregnant women. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
Authors: Ousseny Zerbo; G Thomas Ray; Lea Zhang; Kristin Goddard; Bruce Fireman; Alyce Adams; Saad Omer; Martin Kulldorff; Nicola P Klein Journal: Am J Epidemiol Date: 2020-11-02 Impact factor: 4.897