TY - JOUR
T1 - Benefit of early initiation of influenza antiviral treatment to pregnant women hospitalized with laboratory-confirmed influenza
AU - Oboho, Ikwo K.
AU - Reed, Carrie
AU - Gargiullo, Paul
AU - Leon, Michelle
AU - Aragon, Deborah
AU - Meek, James
AU - Anderson, Evan J.
AU - Ryan, Patricia
AU - Lynfield, Ruth
AU - Morin, Craig
AU - Bargsten, Marisa
AU - Zansky, Shelley M.
AU - Fowler, Brian
AU - Thomas, Ann
AU - Lindegren, Mary Lou
AU - Schaffner, William
AU - Risk, Ilene
AU - Finelli, Lyn
AU - Chaves, Sandra S.
N1 - Funding Information:
Acknowledgments. We thank Kyle Openo, MPH, and Monica M. Farley, MD (Georgia Emerging Infections Program), Susan Peters, DVM, MPH (Michigan Department of Community Health), Gretchen Rothrock, MPH (California Emerging Infections Program), and the Rhode Island Department of Health for the data provided during the 2010-2014 influenza seasons.
Publisher Copyright:
© The Author 2016.
PY - 2016/8/15
Y1 - 2016/8/15
N2 - 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.
AB - 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.
KW - Early antiviral treatment
KW - Influenza
KW - Influenza antiviral treatment
KW - Length of stay
KW - Pregnancy
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U2 - 10.1093/infdis/jiw033
DO - 10.1093/infdis/jiw033
M3 - Article
C2 - 26908745
AN - SCOPUS:84988944436
SN - 0022-1899
VL - 214
SP - 507
EP - 515
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -