A large, population-based study of 2009 pandemic influenza a virus subtype H1N1 infection diagnosis during pregnancy and outcomes for mothers and neonates

Craig Hansen, Sheila Desai, Christine Bredfeldt, Craig Cheetham, Mia Gallagher, De Kun Li, Marsha A. Raebel, Karen Riedlinger, David K. Shay, Mark Thompson, Robert Davis

Research output: Contribution to journalArticle

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Abstract

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-for-gestational-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.

Original languageEnglish (US)
Pages (from-to)1260-1268
Number of pages9
JournalJournal of Infectious Diseases
Volume206
Issue number8
DOIs
StatePublished - Oct 15 2012
Externally publishedYes

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Pandemics
Pregnancy Outcome
Orthomyxoviridae
Human Influenza
Mothers
Newborn Infant
Pregnant Women
Infection
Population
Antiviral Agents
Odds Ratio
Influenza A virus
Hospitalization
Small for Gestational Age Infant
Viruses
H1N1 Subtype Influenza A Virus
Pregnancy
Live Birth
Virus Diseases
Therapeutics

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Infectious Diseases

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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. / Hansen, Craig; Desai, Sheila; Bredfeldt, Christine; Cheetham, Craig; Gallagher, Mia; Li, De Kun; Raebel, Marsha A.; Riedlinger, Karen; Shay, David K.; Thompson, Mark; Davis, Robert.

In: Journal of Infectious Diseases, Vol. 206, No. 8, 15.10.2012, p. 1260-1268.

Research output: Contribution to journalArticle

Hansen, C, Desai, S, Bredfeldt, C, Cheetham, C, Gallagher, M, Li, DK, Raebel, MA, Riedlinger, K, Shay, DK, Thompson, M & Davis, R 2012, '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, vol. 206, no. 8, pp. 1260-1268. https://doi.org/10.1093/infdis/jis488
Hansen, Craig ; Desai, Sheila ; Bredfeldt, Christine ; Cheetham, Craig ; Gallagher, Mia ; Li, De Kun ; Raebel, Marsha A. ; Riedlinger, Karen ; Shay, David K. ; Thompson, Mark ; Davis, Robert. / A large, population-based study of 2009 pandemic influenza a virus subtype H1N1 infection diagnosis during pregnancy and outcomes for mothers and neonates. In: Journal of Infectious Diseases. 2012 ; Vol. 206, No. 8. pp. 1260-1268.
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abstract = "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-for-gestational-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.",
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AU - Bredfeldt, Christine

AU - Cheetham, Craig

AU - Gallagher, Mia

AU - Li, De Kun

AU - Raebel, Marsha A.

AU - Riedlinger, Karen

AU - Shay, David K.

AU - Thompson, Mark

AU - Davis, Robert

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