Pandemic Influenza and Pregnant Women: Summary of a Meeting of Experts

Rasmussen, Sonja A.; Jamieson, Denise J.; MacFarlane, Kitty; Cragan, Janet D.; Williams, Jennifer L.; Henderson, Zsakeba

doi:10.2105/ajph.2008.152900

Cited by 104 publications

(72 citation statements)

References 49 publications

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“…Our experience during the pandemic is in accordance with the empiric treatment of pregnant women with suspected influenza [26,28]. In addition, almost all of our patients who died were seen in consultation prior to hospitalization and are therefore presumed to have had access to care.…”

Section: Discussionsupporting

confidence: 60%

Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia

Rojas-Suarez¹,

Paternina-Caicedo

Cuevas

et al. 2013

Journal of Perinatal Medicine

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Aims: The 2009 H1N1 pandemic illustrated the higher morbidity and mortality from viral infections in peripartum women. We describe clinical features of women who recently died of H1N1 in Colombia. Methods: This is a case series study that was gathered through a retrospective record review of all maternal H1N1 deaths in the country. The national mortality database of confirmed mortality from H1N1 in pregnancy and up to 42 days after delivery was reviewed during the H1N1 season in 2009. Women with H1N1 infections were confirmed by the laboratory of virology. Demographic, clinical, and laboratory data were reviewed. Statistical analyses were performed and median values of non-parametric data were reported with inter-quartile range (IQR). Results: A total of 23 H1N1 maternal deaths were identified. Eighty-three percent occurred in the third trimester. None of the mothers who died had received influenza vaccination. The median time from symptom onset to the initiation of antiviral treatment was 8.8 days (IQR 5.8-9.8). Five fatalities did not receive any anti-viral therapy. Median PaO 2 /FiO 2 on day 1 was 80 (IQR, 60-98.5). All patients required inotropic support and mechanical ventilation with barotrauma-related complications of mechanical ventilation occurring in 35% of patients. Conclusion: In Colombia, none of the women suffering H1N1-related maternal deaths had received vaccination against the disease and most had delayed or had no antiviral therapy. Given the lack of evidence-based clinical predictors to identify women who are prone to die from H1N1 in pregnancy, following international guidelines for vaccination and initiation of antiviral therapy in suspected cases would likely improve outcomes in developing countries.

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Section: Discussionsupporting

confidence: 60%

Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia

Rojas-Suarez¹,

Paternina-Caicedo

Cuevas

et al. 2013

Journal of Perinatal Medicine

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“…A meeting designed to integrate scientific evidence and expert opinion (5) in 2008 in the USA concluded that pregnant women should be considered a high-priority group for receipt of vaccine, and that increased seasonal influenza vaccine coverage may improve vaccine uptake in a pandemic (5). The WHO recommends that pregnant women should be given the highest vaccination priority (6).…”

Section: Introductionmentioning

confidence: 99%

Influenza 2014–2015 among pregnant Japanese women: primiparous vs multiparous women

Yamada

Kawakami

Yoshida

et al. 2016

Eur J Clin Microbiol Infect Dis

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Objectives: This study was performed to determine whether multiparous pregnant women are prone to influenza. Methods:A questionnaire survey was conducted at 19 centres located throughout Japan, targeting all 6694 postpartum women within 7 days after birth before leaving the hospital. All women gave birth during the study period between March 1, 2015, and July 31, 2015. Data regarding vaccination and influenza infection in or after October 2014, age, previous experience of childbirth, and number and ages of cohabitants were collected.Results: Seventy-eight percent (n = 5,197) of women given questionnaires responded.Of these, 2,661 (51%) and 364 (7.0%) women reported having been vaccinated and having contracted influenza, respectively. Multiparous women had a higher risk of compared to primiparous women. The risk of influenza increased with increasing number of cohabitants: 4.8% (100/2,089), 7.5%, (121/1,618), 9.0%, (71/785), and 10.4% (58/557) for women with 1, 2, 3, and ≥ 4 cohabitants, respectively. Conclusions:Family size is a risk factor for influenza infection in pregnancy.

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“…The U.S. Centers for Disease Control and Prevention (CDC) subsequently developed prevention, treatment, and control recommendations for pregnant women in the event of an influenza pandemic (18,19). During the pandemic (20), experts debated the most appropriate treatments for use in pregnancy; however, limited data were available at that time (21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

Pandemic Influenza A (H1N1) Infection in Pregnant and Nonpregnant Women in Spain (2009–2010)

Suárez-Varela

Gónzález-Candelas

Astray³

et al. 2014

Jpn J Infect Dis

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SUMMARY:The present study aimed to compare the main features of infection with pandemic influenza A virus in pregnant and nonpregnant women admitted to hospitals in Spain during the first waves of the 2009-2010 influenza pandemic. This was a prospective (November 2009 to June 2010), multicenter observational study. All cases were women of reproductive age who had not been vaccinated against seasonal or pandemic influenza A. Influenza infection was confirmed by reverse transcriptionpolymerase chain reaction (RT-PCR). The sociodemographic and clinical data of all cases were reviewed. A total of 219 inpatients, including 49 pregnant women and 170 nonpregnant women, were enrolled in the study upon admission to participating hospitals. The most substantially different symptoms between the groups were respiratory distress and unilobar consolidation, both of which were more frequent among nonpregnant women. Antibiotics and systemic corticosteroids were more frequently used in nonpregnant women; however, there were no differences in the rates of treatment with antivirals. Our findings indicated that the compared with nonpregnant women, pregnant women in this study did not have significantly different symptoms and were not at increased risk of complications from pandemic influenza virus infection.

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Pandemic Influenza and Pregnant Women: Summary of a Meeting of Experts

Cited by 104 publications

References 49 publications

Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia

Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia

Influenza 2014–2015 among pregnant Japanese women: primiparous vs multiparous women

Pandemic Influenza A (H1N1) Infection in Pregnant and Nonpregnant Women in Spain (2009–2010)

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Pandemic Influenza and Pregnant Women: Summary of a Meeting of Experts

Cited by 104 publications

References 49 publications

Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia

Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia

Influenza 2014–2015 among pregnant Japanese women: primiparous vs multiparous women

Pandemic Influenza A (H1N1) Infection in Pregnant and Nonpregnant Women in Spain (2009&ndash;2010)

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Pandemic Influenza A (H1N1) Infection in Pregnant and Nonpregnant Women in Spain (2009–2010)