Influenza infections in the 2014–2015 season and pregnancy outcomes (original) (raw)

Status of Pandemic Influenza Vaccination and Factors Affecting It in Pregnant Women in Kahramanmaras, an Eastern Mediterranean City of Turkey

PLoS ONE, 2010

Background: Pregnant women are a target group for receipt of influenza vaccine because there appears to be an elevated mortality and morbidity rate associated with influenza virus infection in pregnant women. The goal of this study is to determine the factors affecting the decisions of pregnant women in Turkey to be vaccinated or not for 2009 H1N1 influenza. Methodology: We enrolled 314 of 522 (60.2%) pregnant women who attended to the antenatal clinics of the Medical Faculty of Kahramanmaras Sutcuimam University's Department of Gynecology and Obstetrics between December 23, 2009, and February 1, 2010. We developed a 48-question survey which was completed in a face-to-face interview at the clinic with each pregnant woman.

Risk Factors Associated with Outcomes of Seasonal Influenza in Pregnant Women Referring to Healthcare Centers in Iran in 2015 - 2016

Archives of Clinical Infectious Diseases, 2019

Background: Influenza causes high mortality rate among pregnant women, while morbidity and mortality cases of this disease and its side effects among pregnant women can be simply prevented by vaccination and reducing risk factors such as cardiovascular diseases, diabetes, hypertension, etc. Objectives: Hence, this study was conducted to investigate the risk factors and mortality rate of seasonal influenza among pregnant women referring to healthcare centers in Iran during 2015-2016. Methods: This case-control study was conducted to examine the odds ratio of seasonal influenza among pregnant women with seasonal influenza who had referred to all healthcare centers in Iran with severe respiratory disease symptoms during 2015-2016. The statistical population consisted of 2,080 pregnant women of whom, 24 dead women constituted the case group and 100 randomly selected living women constituted the control group. A researcher-made checklist was used for data collection. The collected data were analyzed using the statistical test of the odds ratio with SPSS-22 software. Results: Mean (standard deviation) of age was 31 (2.3) and 34 (3.8) in living and dead pregnant women, respectively. The most frequent type of conflicting influenza virus was H1N1 in both case and control groups (83% and 71%, respectively). There was a significant difference between case and control groups in the risk factors including diabetes (P = 0.003), blood pressure (P = 0.001), obesity (P = 0.026), cardiovascular diseases (P = 0.001), renal diseases (P = 0.013), and respiratory diseases (P = 0.012). Among these risk factors, the highest odds ratio (OR) was related to cardiovascular diseases (OR = 24), blood pressure (OR = 16.3), and diabetes (OR = 12.9), in sequence. Oseltamivir prescribed to all patients in the control group and 92% of patients in the case group. Seven patients in the control group and none in the case group had a history of influenza vaccination. Conclusions: It is necessary to take steps and underpin training programs to reduce the risk factors of seasonal influenza among pregnant women based on the national vaccination guidelines.

Pregnancy and H1N1 infection in Southeast Turkey

The Journal of Infection in Developing Countries, 2012

Introduction: H1N1 Influenza made a great impact a worldwide, as well as in Turkey, in 2009. Clinical experiences have shown that it had a more serious prognosis in pregnant women. In this report, we summarize the cases of 16 pregnant women with H1N1 Influenza. Methodology: The study included 16 pregnant women hospitalized in Dicle University Hospital with complaints of fever, sore throat, cough and myalgia between October and December 2009. The diagnosis of pandemic H1N1 Influenza was confirmed on nasopharyngeal specimens using real-time reverse-transcriptase polymerase chain reaction (RT-PCR) in all patients. Patients who had the same complaints but were not diagnosed as H1N1 Influenza were excluded. The epidemiological, clinical, diagnostic, and outcome features of the patients were recorded. Results: The median age of the patients was 27 years (range 18-41 years). The mean gestational age was 25.4 weeks (range 5-38 weeks). Two cases were twin pregnancy. Two cases had co-morbid d...

Seasonal and 2009 pandemic influenza A (H1N1) virus infection during pregnancy: a population-based study of hospitalized cases

American Journal of Obstetrics and Gynecology, 2011

T he emergence of 2009 pandemic influenza A (H1N1) virus (2009 H1N1) resulted in the first influenza pandemic in over 40 years. The Centers for Disease Control and Prevention (CDC) estimated that about 61 million people were infected, 274,000 were hospitalized, and about 12,740 died due to 2009 H1N1 in the United States. 1 About 90% of all hospitalizations and 87% of all deaths during the 2009 H1N1 pandemic were among people Ͻ65 years in contrast with experience from seasonal influenza when about 40% of all hospitalizations and 10% of deaths were found in this age group. 1 It is well recognized that pregnancy represents a risk factor for influenza complications and death during both pandemic and seasonal influenza. 2-6 Thus, with illness being widespread among the younger segments of the population We sought to describe characteristics of hospitalized reproductive-aged (15-44 years) women with seasonal (2005/2006 through 2008/2009) and 2009 pandemic influenza A (H1N1) virus infection. We used population-based data from the Emerging Infections Program in 10 US states, and compared characteristics of pregnant (n ϭ 150) and nonpregnant (n ϭ 489) seasonal, and pregnant (n ϭ 489) and nonpregnant (n ϭ 1088) pandemic influenza cases using 2 and Fisher's exact tests. Pregnant women represented 23.5% and 31.0% of all reproductive-aged women hospitalized for seasonal and pandemic influenza, respectively. Significantly more nonpregnant than pregnant women with seasonal (71.2% vs 36.0%) and pandemic (69.7% vs 31.9%) influenza had an underlying medical condition other than pregnancy. Antiviral treatment was significantly more common with pandemic than seasonal influenza for both pregnant (86.5% vs 24.0%) and nonpregnant (82.0% vs 55.2%) women. Pregnant women comprised a significant proportion of influenza-hospitalized reproductive-aged women, underscoring the importance of influenza vaccination during pregnancy.

The Prevalence of Seasonal Influenza Vaccination in Pregnant Women Referring to Tertiary Hospitals of Kerman, Iran

Shiraz E-Medical Journal, 2020

Background: Influenza vaccination is the most effective strategy to prevent comorbidity and mortality of this infection in pregnant women. Objectives: The current study aimed at evaluating the influenza vaccination rate and its related factors among pregnant women. Methods: The current cross-sectional study was conducted on 520 pregnant women referring to antenatal clinics of tertiary hospitals affiliated to Kerman University of Medical Sciences from January to April 2019 in Kerman city, Iran. The collected data through a form distributed among the subjects were analyzed using SPSS version 22. Results: The influenza vaccination coverage rate was 30.0% (95% confidence interval (CI): 26.1 - 34.1) among the pregnant women. Age older than 30 years (AOR = 3.79; 95%CI: 1.55 - 9.24), being employed (AOR = 2.44; 95%CI: 1.01 - 5.88), having an underlying chronic disease (AOR = 4.39; 95%CI: 1.33 - 14.51), receiving recommendation to undergo influenza vaccination (AOR = 65.76; 95%CI: 11.04 - 3...

Severity of influenza and noninfluenza acute respiratory illness among pregnant women, 2010-2012

American journal of obstetrics and gynecology, 2014

The objective of the study was to identify characteristics of influenza illness contrasted with noninfluenza acute respiratory illness (ARI) in pregnant women. ARI among pregnant women was identified through daily surveillance during 2 influenza seasons (2010-2012). 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. Of 292 pregnant women with ARI, 100 tested positive for influenza viruses. Women with influenza illnesses reported higher symptom severity than those with noninfluenza ARI (median score, 18 vs 16 of 36; P < .05) and were more likely to report severe subjective feverishness (18% vs 5%; P < .00...

Influenza A H1N1 virus infection among pregnant women in a tertiary hospital in Belgrade, Serbia

The Journal of Infection in Developing Countries, 2018

Introduction: Pregnant women are at higher risk of developing severe influenza. Our aim was to analyze clinical course and risk factors for fatal outcome in pregnant women with influenza (H1N1) infection. Methodology: This retrospective study enrolled eleven pregnant women with confirmed Influenza A (H1N1) infection treated in the Clinic for Infectious and Tropical Diseases, Belgrade, Serbia in a 6-years period. Results: The mean age of pregnant women was 28.9 ± 5.2 years, and mean gestational age was 23.1 ± 7.0 weeks. Nine (81.8%) pregnant women had pneumonia (six had interstitial and three had bacterial pneumonia). Pregnant women developed pneumonia more often than other women in the reproductive period, but without statistical significance (81.8% vs. 65.7%, p = 0.330, OR (95% CI) 2.35 (0.47-11.80)). Nine (81.8%) pregnant women recovered. None of them experienced preterm delivery or abortion. Two women (18.2%) died due to acute respiratory distress syndrome. In one of them fetal d...

A Large, Population-Based Study of 2009 Pandemic Influenza A Virus Subtype H1N1 Infection Diagnosis During Pregnancy and Outcomes for Mothers and Neonates

Journal of Infectious Diseases, 2012

Background. Pregnant women were at increased risk for serious outcomes of 2009 pandemic influenza A virus subtype H1N1 (influenza A[H1N1]pdm09) infection, but little is known about the overall impact of the pandemic on neonatal and maternal outcomes. Methods. We identified live births that occurred from 1 July 2008 through 31 May 2010 in 5 Kaiser Permanente regions. Pregnant women were considered to have influenza if they had a positive result of a laboratory test for influenza virus or if they received a diagnosis of influenza during a period in which seasonal influenza virus or A(H1N1)pdm09 was the predominant circulating virus. Results. There were 111 158 births from 109 015 pregnancies involving 107 889 mothers; 368 pregnant women (0.3%) received a diagnosis of influenza due to seasonal virus, and 959 (0.9%) received a diagnosis of influenza due to A(H1N1)pdm09; 107 688 did not receive an influenza diagnosis. Pregnant women with influenza due to A(H1N1)pdm09 were more likely than women with seasonal influenza infection to be hospitalized within 30 days of the diagnosis (27% vs 12%; odds ratio [OR], 2.84 [95% confidence interval {CI}, 2.01-4.02]). Pregnant women with A(H1N1)pdm09 who started antiviral treatment ≥2 days after the diagnosis were significantly more likely to be hospitalized than those who started antiviral treatment <2 days after diagnosis (OR, 3.43 [95% CI, 1.55-7.56]). Mothers with seasonal influenza virus infection had an increased risk for having a small-forgestational-age infant (OR, 1.59 [95% CI, 1.15-2.20]). Conclusions. In this large, geographically diverse population, A(H1N1)pdm09 infection increased the risk for hospitalization during pregnancy. Late initiation of antiviral treatment was also associated with an increased risk for hospitalization.

Influenza epidemiology and immunization during pregnancy: Final report of a World Health Organization working group

Vaccine, 2017

From 2014 to 2017, the World Health Organization convened a working group to evaluate influenza disease burden and vaccine efficacy to inform estimates of maternal influenza immunization program impact. The group evaluated existing systematic reviews and relevant primary studies, and conducted four new systematic reviews. There was strong evidence that maternal influenza immunization prevented influenza illness in pregnant women and their infants, although data on severe illness prevention were lacking. The limited number of studies reporting influenza incidence in pregnant women and infants under six months had highly variable estimates and underrepresented low- and middle-income countries. The evidence that maternal influenza immunization reduces the risk of adverse birth outcomes was conflicting, and many observational studies were subject to substantial bias. The lack of scientific clarity regarding disease burden or magnitude of vaccine efficacy against severe illness poses cha...

Neonatal characteristics and outcomes of pregnancies complicated by influenza infection during the 2009 pandemic

American Journal of Obstetrics and Gynecology, 2011

The purpose of this study was to describe the neonatal characteristics and outcomes of infants who were born during the 2009 H1N1 influenza pandemic. A prospective cohort of pregnant women with influenza-like illness (ILI) was enrolled between the months of June 2009 and March 2010. Neonatal characteristics, complications, and outcomes were recorded. Forty-five women were included in the study. Birth outcomes were available in 41 cases; 16 women had 2009 H1N1 infection, and the remaining 25 women who tested negative were included in the ILI group. Live births were similar in both groups. Average gestational age at delivery was Ͼ39 weeks; Apgar scores and cord gas pH values were similar. Birthweights in the 2009 H1N1 group were on average 285 g lower (3186 vs 3471 g; P ϭ .04). Three infants were admitted to the neonatal intensive care unit. In this cohort, 2009 H1N1 infection during pregnancy was associated with a lower birthweight when compared with ILI in pregnancy.