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2329. Incidences and Characteristics of Influenza among Pregnant Women in Middle-Income Countries: Preliminary Results of the Pregnancy and Influenza Multinational Epidemiologic (PRIME) Study

Open Forum Infectious Diseases(2019)SCI 3区SCI 4区

Centers for Disease Control and Prevention | US Naval Medical Research Unit No. 6 | Queen Sirikit National Institute of Child Health | Lata Medical Research Foundation | Abt Associates | Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration | Hospital Nacional Arzobispo Loayza | Instituto Nacional Materno Perinatal | Hospital Nacional Docente Madre Niño San Bartolomé | Hospital Nacional Dos de Mayo | Thailand MOPH - US CDC Collaboration | Abt Associates Inc. | Rollins School of Public Health | Dhruv Pathology and Molecular Diagnostic Lab | Dhruv Pathology and Molecular Diagnostics | Armed Forces Research Institute of Medical Sciences | US Centers for Disease Control and Prevention

Cited 1|Views30
Abstract
Abstract Background The World Health Organization recommends influenza vaccination for pregnant women. However, few data exist on influenza incidence and clinical course among pregnant women in middle-income countries where influenza vaccine use during pregnancy is often limited. We conducted a prospective cohort study of pregnant women to estimate incidences of influenza in Lima, Peru; Bangkok, Thailand; and Nagpur, India. Methods Prior to and early in the 2017 and 2018 influenza seasons, we enrolled pregnant women aged > 18 years with expected delivery dates > 8 weeks after the start of the season. We contacted women twice weekly until end of pregnancy to identify illnesses with myalgia, cough, runny nose, sore throat, or difficulty breathing and collected nasal swabs from symptomatic women for influenza real-time reverse transcription polymerase chain reaction testing. Using 2017 cohort data, we calculated crude incidences per 10,000 pregnancy-months during influenza season by site and trimester and overall incidence weighted for population of women of childbearing age in each country. Results We enrolled 4774 women with a median age of 26 years (interquartile range [IQR] 23–31) and gestational age of 20 weeks (IQR 15–24); 15% received influenza vaccine. Local influenza seasons spanned 4.5–8 months. Overall, 143 participants (3%) had influenza (113 (79%) influenza A and 30 (21%) influenza B). Weighted influenza incidence was 88.7/10,000 pregnancy-months (95% CI 68.6–114.8), though incidences varied up to two-fold by site (Figure 1). Incidences did not differ by pregnancy trimester (Figure 2). Among the 143 influenza episodes, the median duration was 7 days (IQR 5–10), 30% involved fever or chills, 43% disrupted daily activities, 47% prompted medical attention, 4% were associated with hospitalization, and < 1% were treated with antiviral medications. Conclusion Overall, pregnant women had an average risk of influenza of 0.9% per month of pregnancy spent in the influenza season with almost half of illnesses disrupting daily activities and prompting medical attention. Influenza-associated hospitalization was infrequent. These findings provide valuable inputs to estimate illnesses averted by vaccine programs and evaluate their cost–benefit among pregnant women in middle-income countries. Disclosures All authors: No reported disclosures.
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要点】:该研究通过前瞻性队列研究,在中低收入国家的秘鲁利马、泰国曼谷和印度纳格浦尔对孕妇流感发生率和临床过程进行了估算,发现孕妇流感发生率为88.7/10,000妊娠月,流感疫苗的接种率较低,为15%。

方法】:研究者在2017和2018年流感季节前及早期,招募了年龄大于18岁、预计分娩日期在流感季节开始后8周以上的孕妇,通过每周两次的电话联系来识别流感样病例,并对有症状的孕妇进行流感实时反转录聚合酶链反应测试。

实验】:共招募了4774名孕妇,中位年龄26岁,中位孕周20周;通过对这些孕妇的监测,确定了流感的发生率,并收集了流感相关的临床症状和结果数据。结果显示,3%的参与者患有流感,其中79%为流感A型,21%为流感B型。