tetano
Editor, Senior Moderator
J Infect Dis. 2016 Feb 3. pii: jiw033. [Epub ahead of print]
[h=1]The benefit of early influenza antiviral treatment of pregnant women hospitalized with laboratory-confirmed influenza.[/h] Oboho I[SUP]1[/SUP], Reed C[SUP]2[/SUP], Gargiullo P[SUP]2[/SUP], Leon M[SUP]2[/SUP], Aragon D[SUP]3[/SUP], Meek J[SUP]4[/SUP], Anderson EJ[SUP]5[/SUP], Ryan P[SUP]6[/SUP], Lynfield R[SUP]7[/SUP], Morin C[SUP]7[/SUP], Bargsten M[SUP]8[/SUP], Zansky S[SUP]9[/SUP], Fowler B[SUP]10[/SUP], Thomas A[SUP]11[/SUP], Lindegren ML[SUP]12[/SUP], Schaffner W[SUP]12[/SUP], Risk I[SUP]13[/SUP], Finelli L[SUP]2[/SUP], Chaves SS[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] We describe the impact of early antiviral treatment among pregnant women hospitalized with laboratory-confirmed influenza (2010-14 influenza seasons).
[h=4]METHODS:[/h] Severe influenza was defined as intensive care unit admission, mechanical ventilation, respiratory failure, pulmonary embolism, sepsis, or death. Within severity stratum, we used parametric survival analysis to compare length of stay (LOS) by timing of antiviral treatment, adjusting for underlying conditions, influenza vaccination, and pregnancy trimester.
[h=4]RESULTS:[/h] Among 865 pregnant women, median age was 27 years (interquartile range [IQR], 23-31). Most (68%) were healthy, and 85% received antiviral treatment. Sixty-three (7%) women had severe influenza, 4 died. Severity was associated with preterm delivery and fetal loss. Women with severe influenza were less likely to be vaccinated than those without (14% vs. 26%, p=0.03). Comparing women treated with antivirals ≤2 vs. >2 days from illness onset, median LOS (days) was respectively 2.2 (IQR 0.9-5.8; n=8) vs. 7.8 (IQR 3.0-20.6; n=7) for severe (p=0.03), and 2.4 (IQR 2.3-2.5; n=153) vs. 3.1 (IQR 2.8-3.5; n=62) for non-severe influenza (p<0.01).
[h=4]CONCLUSIONS:[/h] Early influenza antiviral treatment for pregnant women hospitalized with influenza may reduce LOS, especially if severe influenza. Influenza during pregnancy is associated with maternal and infant morbidity and annual influenza vaccination is warranted.
Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
PMID: 26908745 [PubMed - as supplied by publisher]
[h=1]The benefit of early influenza antiviral treatment of pregnant women hospitalized with laboratory-confirmed influenza.[/h] Oboho I[SUP]1[/SUP], Reed C[SUP]2[/SUP], Gargiullo P[SUP]2[/SUP], Leon M[SUP]2[/SUP], Aragon D[SUP]3[/SUP], Meek J[SUP]4[/SUP], Anderson EJ[SUP]5[/SUP], Ryan P[SUP]6[/SUP], Lynfield R[SUP]7[/SUP], Morin C[SUP]7[/SUP], Bargsten M[SUP]8[/SUP], Zansky S[SUP]9[/SUP], Fowler B[SUP]10[/SUP], Thomas A[SUP]11[/SUP], Lindegren ML[SUP]12[/SUP], Schaffner W[SUP]12[/SUP], Risk I[SUP]13[/SUP], Finelli L[SUP]2[/SUP], Chaves SS[SUP]2[/SUP].
[h=3]Author information[/h]
- [SUP]1[/SUP]Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA.
- [SUP]2[/SUP]Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA.
- [SUP]3[/SUP]Colorado Department of Public Health and Environment, Denver, CO.
- [SUP]4[/SUP]Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT.
- [SUP]5[/SUP]Emory University School of Medicine, Atlanta, GA VA Medical Center, Atlanta, GA.
- [SUP]6[/SUP]Maryland Department of Health and Mental Hygiene, Baltimore, MD.
- [SUP]7[/SUP]Minnesota Department of Health, St. Paul, MN.
- [SUP]8[/SUP]New Mexico Department of Health, Santa Fe, NM.
- [SUP]9[/SUP]New York State Department of Health, Albany, NY.
- [SUP]10[/SUP]Ohio Department of Health, Columbus, OH.
- [SUP]11[/SUP]Emerging Infections Program, Oregon Public Health Division, Portland, OR.
- [SUP]12[/SUP]Vanderbilt University School of Medicine, Nashville, TN.
- [SUP]13[/SUP]Salt Lake County Health Department, Salt Lake City, UT.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] We describe the impact of early antiviral treatment among pregnant women hospitalized with laboratory-confirmed influenza (2010-14 influenza seasons).
[h=4]METHODS:[/h] Severe influenza was defined as intensive care unit admission, mechanical ventilation, respiratory failure, pulmonary embolism, sepsis, or death. Within severity stratum, we used parametric survival analysis to compare length of stay (LOS) by timing of antiviral treatment, adjusting for underlying conditions, influenza vaccination, and pregnancy trimester.
[h=4]RESULTS:[/h] Among 865 pregnant women, median age was 27 years (interquartile range [IQR], 23-31). Most (68%) were healthy, and 85% received antiviral treatment. Sixty-three (7%) women had severe influenza, 4 died. Severity was associated with preterm delivery and fetal loss. Women with severe influenza were less likely to be vaccinated than those without (14% vs. 26%, p=0.03). Comparing women treated with antivirals ≤2 vs. >2 days from illness onset, median LOS (days) was respectively 2.2 (IQR 0.9-5.8; n=8) vs. 7.8 (IQR 3.0-20.6; n=7) for severe (p=0.03), and 2.4 (IQR 2.3-2.5; n=153) vs. 3.1 (IQR 2.8-3.5; n=62) for non-severe influenza (p<0.01).
[h=4]CONCLUSIONS:[/h] Early influenza antiviral treatment for pregnant women hospitalized with influenza may reduce LOS, especially if severe influenza. Influenza during pregnancy is associated with maternal and infant morbidity and annual influenza vaccination is warranted.
Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
PMID: 26908745 [PubMed - as supplied by publisher]