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[Medscape] Pregnant women hospitalized with H1N1 flu are at higher risk for adverse events

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According to a new study, pregnant women hospitalized with the H1N1 flu strain are more likely to experience serious adverse outcomes than those with the H3N2 flu.

As reported by researchers in the Annals of Internal Medicine, an analysis of data from 9,652 women hospitalized with the flu. Data suggest that pregnant women infected with H1H1 are at increased risk for intensive care (ICU) and death.

They also note that one-third of women of reproductive age hospitalized with the flu are pregnant. This number seems very high because on average in the US at any given time only 5% of women of reproductive age are pregnant.

“Pregnant women with influenza A(H1N1) are twice as likely to experience severe disease progression in humans,” said Dr. Rachel of the Centers for Disease Control and Prevention at Atlanta, first author of the study. mothers compared with pregnant women infected with influenza A(H3N2)”.

“In the study, only 32% of pregnant women hospitalized with influenza received the flu vaccine.”

“Although this study was not designed to evaluate the effectiveness of the vaccine, in the adjusted analyzes pregnant women who received the vaccine had a lower risk of severe symptoms compared with those who received the vaccine. unvaccinated people”.

Pregnant women are a high-priority group for flu vaccination, and these data highlight opportunities to improve flu vaccine reception among pregnant women.

To take a closer look at the impact of influenza on pregnant women, the researchers conducted a repeat cross-sectional analysis of data from FluSurv-NET, a large multicenter network funded by the CDC. support, conducting population-based surveillance of laboratory-confirmed influenza hospitalizations. The analysis included patients in all age groups and represented approximately 9% of the US population.

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Among women aged 15 to 44 who were hospitalized with influenza during flu seasons from 2010-2011 to 2018-2019, 2,690 were pregnant.

Their median age was 28, with 36% being non-Hispanic white, 29% non-Hispanic black women, and 20% being Hispanic or Latino.

Most mothers (68%) were in the third trimester and 42% of them had one or more underlying medical conditions, such as asthma, chronic metabolic disease and obesity.

Only 32% were vaccinated and 88% were treated with antibiotics.

Overall, 5% of patients were transferred to the ICU, 2% required mechanical ventilation, and 0.3% died.

Following appropriate vaccination for influenza season, location of surveillance, age, three stages of pregnancy, and immunization status, patients with H1N1 infection are more likely to experience life-threatening conditions than those infected with H3N2 ( adjusted hazard ratio, 1.9; 95% CI, 1.3 – 2.8).

Most of the patients were still pregnant until discharge, 96% of the fetuses were delivered, while 3% had a miscarriage.

Dr. Holstein: “The flu is especially dangerous for pregnant women because of changes in the immune, cardiovascular, and lung systems during pregnancy (which can last up to 2 weeks postpartum). can make the mother more susceptible to the flu and cause dangerous complications.”

“The flu vaccine is always the best way to protect mother and baby from flu.”

Dr. Ray: “Health care providers should make sure they provide immediate antibiotic treatment for pregnant women with the flu.”

“The study was done before the COVID-19 pandemic and one question was raised about how to reach patients with flu-like conditions during an ongoing epidemic. There is a need to be on high alert for both of these infections.”

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Dr Ray, who was not involved in the study, said: ‘One disturbing message from the study is that there are disparities in vaccination rates, with Hispanic or non-white women having higher rates. lower vaccinations”.

“This is a hole that we should fill.”

Frederick Friedman, associate professor and vice president of academic affairs in obstetrics, gynecology, and reproductive sciences at the Icahn School of Medicine at Mount Sinai and director of ob-gyn services at Elmhurst Hospital Center , in New York City, said: “We already know that sometimes pregnant patients are more susceptible to colds, have higher hospitalizations, and are more susceptible to serious illnesses than women of younger age. similar age but not pregnant”.

“The researchers found that the incidence of severe illness in H1N1 flu doubled. Previous studies have shown a sevenfold increased risk.”

Therefore, it is highly recommended that pregnant women go for ring injections.

Obviously, vaccination doesn’t completely prevent influenza infection, but it does seem to reduce the incidence and severity of illness.”

THE SOURCE:

https://doi.org/10.7326/M21-4598

Original link: https://www.medscape.com/viewarticle/965728

The article is translated and edited by ykhoa.org – please do not reup without permission!

Translator: GT

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