Program Schedule

The Benefit of Early Influenza Antiviral Treatment of Pregnant Women Hospitalized with Laboratory-Confirmed Influenza

Session: Oral Abstract Session: Epidemiology and Prevention of Infectious Diseases
Saturday, October 11, 2014: 11:30 AM
Room: The Pennsylvania Convention Center: 111-AB
Background: Pregnant women are at increased risk of influenza-related complications, as documented during the 2009 influenza pandemic. We describe demographics, treatment with antivirals and clinical outcomes among pregnant women hospitalized with influenza in the post-2009 pandemic era.  

Methods: We used data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based system, to describe pregnant women aged 15−44 years hospitalized with community-acquired, laboratory-confirmed influenza during the 2010−11 through 2012−13 influenza seasons.  Severe influenza was defined by intensive care unit (ICU) admission or death. We compared women’s characteristics using χ2 and Fisher’s exact tests, and rank sum tests for differences in medians.

Results: During the study period, 631 pregnant women were identified.  The median age was 27 years (interquartile range [IQR], 23−31).  The majority of women (70%) had no underlying medical conditions other than pregnancy, and 20% had asthma (most common underlying condition). Overall, 356 (56%) were in the third trimester of gestation; 138 (22%) delivered during hospitalization, with 34/138 (25%) preterm births (<37 weeks gestation).  Overall, 526 women (83%) were treated with antivirals; those treated were more likely to have a positive rapid influenza test than those not treated (54% vs.33%, p <0.01).  Twenty-five women (4%) had severe influenza (22 ICU admissions, 3 deaths). Those who died received antiviral treatment ≥3 days after illness onset.  Women treated early (i.e., within the first day of admission) had a shorter median length of stay (LOS) (2 days [IQR 1−3]) than those treated after day 1 (5 days [IQR 3−8], p<0.01). Among severe cases, those treated early also had a shorter median LOS (6 days [IQR 2−11]) than those treated later (9 days [IQR 8−11], p=0.21). A minority of women (26%) received influenza vaccine for the season.

Conclusion: Our findings suggest that prompt antiviral treatment for pregnant women hospitalized with influenza may reduce LOS. Influenza during pregnancy is associated with maternal and infant morbidity and annual influenza vaccination is warranted. Physicians should not wait for laboratory test results when influenza is suspected to initiate treatment.

Ikwo Oboho, MD1,2, Carrie Reed, DSc, MPH3, Michelle Leon, MPH1, Gretchen Rothrock, MPH4, Deborah Aragon, MSPH5, James Meek, MPH6, Monica M. Farley, MD7,8, Patricia Ryan, MS9, Susan Peters, DVM, MPH10, Ruth Lynfield, MD11, Craig Morin, MPH11, Marisa Bargsten, MPH12, Shelley M. Zansky, PhD13, Brian Fowler, MPH14, Ann Thomas, MD, MPH15, Elizabeth Mermel, MS16, Mary Lou Lindegren, MD, MPH17, Ilene Risk, MPA18, Lyn Finelli, DrPH, MS1 and Sandra S. Chaves, MD, MSc1, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, (3)Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, (4)California Emerging Infections Program, Oakland, CA, (5)Colorado Department of Public Health & Environment, Denver, CO, (6)Yale Emerging Infections Program, New Haven, CT, (7)Atlanta Veterans Affairs Medical Center, Decatur, GA, (8)Emory University School of Medicine, Atlanta, GA, (9)Maryland Department of Health and Mental Hygiene, Baltimore, MD, (10)Michigan Department of Community Health, Lansing, MI, (11)Minnesota Department of Health, St. Paul, MN, (12)New Mexico Department of Health, Santa Fe, NM, (13)New York State Department of Health, Albany, NY, (14)Ohio Department of Health, Columbus, OH, (15)Emerging Infections Program, Portland, OR, (16)Rhode Island Deparment of Health, Providence, RI, (17)Vanderbilt University School of Medicine, Nashville, TN, (18)Salt Lake County Health Department, Salt Lake City, UT


I. Oboho, None

C. Reed, None

M. Leon, None

G. Rothrock, None

D. Aragon, None

J. Meek, CDC Emerging Infections Program: Investigator, Research grant and Salary

M. M. Farley, None

P. Ryan, None

S. Peters, None

R. Lynfield, None

C. Morin, None

M. Bargsten, None

S. M. Zansky, None

B. Fowler, None

A. Thomas, None

E. Mermel, None

M. L. Lindegren, None

I. Risk, None

L. Finelli, None

S. S. Chaves, None

Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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