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

Hansen, Claus D.; Desai, S; Bredfeldt, Christine; Cheetham, Craig; Gallagher, M. J.; Li, De-Kun; Raebel, Marsha A.; Riedlinger, Karen; Shay, David K.; Thompson, Mark G.; Davis, Robert L.

doi:10.1093/infdis/jis488

Cited by 50 publications

(66 citation statements)

References 17 publications

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“…Five studies [21, 23, 24, 26, 27] gave complete maternal asthma data (Figure 3). Maternal asthma was demonstrated to increase the risk of acquiring influenza A virus infection during pregnancy ( P <0.00001, RR=1.99, 95% CI: 1.67-2.37).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies [20, 21, 24, 26-28] in this meta-analysis included data regarding diabetes. According to the time of diagnosis, these outcomes were divided into three groups: diabetes mellitus before pregnancy (DM), gestational diabetes (GDM) and DM/GDM.…”

Section: Resultsmentioning

confidence: 99%

“…Two included studies [21, 26] reported numbers of pregnant women with anemia during influenza A (H1N1) epidemic. Although they didn’t give the details of patients’ disease, it was revealed that anemia during pregnancy can be a risk for getting influenza A virus (H1N1) infection.…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight

Liu

et al. 2017

Kidney Blood Press Res

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Background/Aims: Impaired pregnancy outcomes, such as low birth weight are associated with increased disease risk in later life, however little is known about the impact of common infectious diseases during pregnancy on birth weight. The study had two aims: a) to investigate risk factors of influenza virus infection during pregnancy, and b) to analyze the impact of influenza virus infection on pregnancy outcome, especially birth weight. Methods: Prospective and retrospective observational studies found in PubMed, MEDLINE, Embase, Google Scholar, and WangFang database were included in this meta analysis. Data of included studies was extracted and analyzed by the RevMan software. Results: Pregnant women with anemia (P=0.004, RR=1.46, 95% CI: 1.13-1.88), obesity (P<0.00001, RR=1.35, 95% CI: 1.25-1.46) and asthma (P<0.00001, RR=1.99, 95% CI: 1.67-2.37) had higher rates of influenza virus infection. Regarding birth outcomes, influenza A virus infection did not affect the likelihood for cesarean section. Mothers with influenza had a higher rate of stillbirth (P=0.04, RR=2.36, 95% CI: 1.05-5.31), and their offspring had low 5-minute APGR Scores (P=0.009, RR=1.39, 95% CI: 1.08-1.79). Furthermore, the rate for birth weight < 2500g (P=0.04, RR=1.71, 95% CI: 1.03-2.84) was increased. Conclusion: Results of this study showed that anemia, asthma and obesity during pregnancy are risk factors influenza A virus infection during pregnancy. Moreover, gestational influenza A infection impairs pregnancy outcomes and increases the risk for low birth weight, a known risk factor for later life disease susceptibility.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight

Liu

et al. 2017

Kidney Blood Press Res

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“…While this finding is subject to some limitations, it suggests the possibility of pregnancy-related differences in influenza severity related to influenza virus type, as has been suggested by other studies [7,8]. One recent study found pregnant women with pH1N1 to be twice as likely to be hospitalized as pregnant women with seasonal influenza [8]. Severity differences related to specific influenza type are also biologically plausible for pregnant women, especially during later trimesters when decreased maternal lung capacity might increase risk for severe disease from influenza virus types [2], such as pH1N1, that target the lower pulmonary lobe [9].…”

Section: Discussionmentioning

confidence: 51%

“…The PFL findings suggest that during the same influenza season, different influenza viruses might predominate among pregnant women than among other groups (Figure 2). While this finding is subject to some limitations, it suggests the possibility of pregnancy-related differences in influenza severity related to influenza virus type, as has been suggested by other studies [7,8]. One recent study found pregnant women with pH1N1 to be twice as likely to be hospitalized as pregnant women with seasonal influenza [8].…”

Section: Discussionmentioning

confidence: 57%

CDC Pregnancy Flu Line: Monitoring Severe Illness Among Pregnant Women with Influenza

Ailes

Newsome

Williams

et al. 2013

Matern Child Health J

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The Centers for Disease Control and Prevention implemented the Pregnancy Flu Line during the influenza A(H1N1)pdm09 (pH1N1) pandemic and continued operation through the 2010–11 influenza season to collect reports of intensive care unit (ICU) admissions and deaths among pregnant women with influenza. The system documented the severe impact of influenza on pregnant women during both seasons with 181 ICU/survivals and 37 deaths reported during the 2009 fall pandemic wave and 69 ICU/survivals and 10 deaths reported in the subsequent influenza season (2010–11). A health department survey suggests PFL participants perceived public health benefits and minimum time burdens.

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Influenza Infection During Pregnancy and Risk of Seizures in Offspring

Lee,

Lin,

Lin

et al. 2024

JAMA Netw Open

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ImportanceSeizure is a common neurological problem among infants and children up to age 6 years. Prenatal exposure to maternal influenza infection has been reported to be associated with childhood seizures.ObjectiveTo evaluate the association between maternal influenza infection and risk of childhood seizures.Designs, Setting, and ParticipantsThis cohort study identified mother-offspring pairs from January 1, 2004, to December 31, 2013, using records in Taiwan’s Maternal and Child Health Database. Mothers who had influenza infection during pregnancy and their first offspring were identified and assigned to the influenza group. Mothers in the control group were those without influenza during pregnancy and were matched 1:4 with mothers in the influenza group by maternal age, offspring sex, and date of delivery. Offspring were followed up until December 31, 2020. Data were analyzed between March 2023 and July 2024.ExposureDiagnosis of influenza infection during pregnancy defined using International Classification of Diseases, Ninth Revision, Clinical Modification codes 487.0, 487.1, and 487.8, or International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes J09, J10, and J11.Main Outcomes and MeasuresThe primary outcome was the association between maternal influenza infection during pregnancy and risk of any type of seizures during childhood, including both epilepsy and febrile seizures. Adjusted hazard ratios (AHRs) and 95% CIs were estimated using Cox proportional hazards regression models. Pregnancy-related complications were collected as covariates.ResultsA total of 1 316 107 mother-offspring pairs were enrolled, of whom 75 835 mothers (predominant maternal age, 25-29 years; 39 324 male offspring [51.9%]) were assigned to the influenza group and 1 240 272 were matched and assigned to the control group (n = 303 340; predominant maternal age, 30-34 years; 157 296 male offspring [51.9%]). In the influenza group, there was a slightly higher prevalence of placenta previa or abruption compared with the control group (1.6% [1241] vs 1.4% [4350]; P &lt; .001). The cumulative risk of seizures was higher among offspring whose mothers had influenza infection. After controlling for potential confounders, the AHRs were 1.09 (95% CI, 1.05-1.14) for seizures, 1.11 (95% CI, 1.06-1.17) for febrile convulsions, and 1.04 (95% CI, 0.97-1.13) for epilepsy. In the subgroup analysis, no statistically significant differences were observed between the trimesters regarding the timing of influenza infection.Conclusions and RelevanceResults of this cohort study suggest that maternal influenza infection during pregnancy was associated with an increased risk of childhood seizures, especially febrile seizures, but not epilepsy. Further studies are needed to elucidate the mechanisms underlying childhood neurological development.

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

Abstract: 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.

Cited by 50 publications

References 17 publications

A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight

A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight

CDC Pregnancy Flu Line: Monitoring Severe Illness Among Pregnant Women with Influenza

Influenza Infection During Pregnancy and Risk of Seizures in Offspring

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