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

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

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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.

LanguageEnglish
Pages1260-1268
Number of pages9
JournalJournal of Infectious Diseases
Volume206
Issue number8
DOIs
Publication statusPublished - 15 Oct 2012

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Hansen, Craig Anthony ; Desai, Sheila ; Bredfeldt, Christine ; Cheetham, Craig ; Gallagher, Mia ; Li, De Kun ; Raebel, Marsha A. ; Riedlinger, Karen ; Shay, David K. ; Thompson, Mark ; Davis, Robert L. / 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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title = "A large, population-based study of 2009 pandemic influenza a virus subtype H1N1 infection diagnosis during pregnancy and outcomes for mothers and neonates",
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.",
author = "Hansen, {Craig Anthony} and Sheila Desai and Christine Bredfeldt and Craig Cheetham and Mia Gallagher and Li, {De Kun} and Raebel, {Marsha A.} and Karen Riedlinger and Shay, {David K.} and Mark Thompson and Davis, {Robert L.}",
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Hansen, CA, Desai, S, Bredfeldt, C, Cheetham, C, Gallagher, M, Li, DK, Raebel, MA, Riedlinger, K, Shay, DK, Thompson, M & Davis, RL 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

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

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

Research output: Contribution to journalArticle

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T1 - A large, population-based study of 2009 pandemic influenza a virus subtype H1N1 infection diagnosis during pregnancy and outcomes for mothers and neonates

AU - Hansen, Craig Anthony

AU - Desai, Sheila

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 L.

PY - 2012/10/15

Y1 - 2012/10/15

N2 - 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.

AB - 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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DO - 10.1093/infdis/jis488

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