Benefit of early initiation of influenza antiviral treatment to pregnant women hospitalized with laboratory-confirmed influenza

Ikwo K. Oboho, Carrie Reed, Paul Gargiullo, Michelle Leon, Deborah Aragon, James Meek, Evan J. Anderson, Patricia Ryan, Ruth Lynfield, Craig Morin, Marisa Bargsten, Shelley M. Zansky, Brian Fowler, Ann Thomas, Mary Lou Lindegren, William Schaffner, Ilene Risk, Lyn Finelli, Sandra S. Chaves

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Background. We describe the impact of early initiation of influenza antiviral treatment among pregnant women hospitalized with laboratory-confirmed influenza during the 2010-2014 influenza seasons. Methods. Severe influenza was defined as illness with ?1 of the following: intensive care unit admission, need for mechanical ventilation, respiratory failure, pulmonary embolism, sepsis, or death.Within severity stratum, we used parametric survival analysis to compare length of stay by timing of antiviral treatment, adjusting for underlying conditions, influenza vaccination, and pregnancy trimester. Results. Among 865 pregnant women, themedian agewas 27 years (interquartile range [IQR], 23-31 years).Most (68%)were healthy, and 85%received antiviral treatment. Sixty-threewomen (7%) had severe influenza, and 4 died. Severitywas associated with pretermdelivery and fetal loss.Womenwithsevere influenzawere less likely tobe vaccinated thanthose without severe influenza (14%vs 26%;P = .03).Among womentreatedwithantivirals?2daysversusthosetreated>2daysfromillnessonset, themedianlengthofstaywas2.2days(interquartilerange [IQR],0.9-5.8days;n = 8)versus7.8days(IQR,3.0-20.6days;n = 7), respectively, forsevereinfluenza(P = .03)and2.4days(IQR,2.3-2.5days; n = 153) versus 3.1 days (IQR, 2.8-3.5 days; n = 62), respectively, for nonsevere influenza (P < .01). Conclusions. Earlyinitiationofinfluenzaantiviraltreatmenttopregnantwomenhospitalizedwithinfluenzamayreducethelengthofstay, especially among those with severe influenza. Influenza during pregnancy is associated with maternal and infantmorbidity, and annual influenza vaccination is warranted.

Original languageEnglish (US)
Pages (from-to)507-515
Number of pages9
JournalJournal of Infectious Diseases
Volume214
Issue number4
DOIs
StatePublished - Aug 15 2016
Externally publishedYes

Keywords

  • Early antiviral treatment
  • Influenza
  • Influenza antiviral treatment
  • Length of stay
  • Pregnancy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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