128 - Characteristics and Outcomes of Pregnant Women Hospitalized with Influenza in the United States, Flusurv-net, 2010-2019

Background: Pregnant women are at high-risk for influenza-associated hospitalization. We used data from the U.S. Influenza Hospitalization Surveillance Network (FluSurv-NET) to characterize pregnant women hospitalized with influenza.

Methods: We included pregnant women (15-44 years) residing within a FluSurv-NET catchment area and hospitalized with laboratory-confirmed influenza between October 1 and April 30, during the 2010–19 influenza seasons. Clinical data were obtained on cases through medical chart abstraction. We examined trends in vaccination coverage and antiviral treatment using the Cochran-Armitage test for trend and characterized maternal interventions and maternal and fetal outcomes during hospitalization.

Results: Of 9,652 women aged 15-44 years hospitalized with influenza, 2,697 (28%) were pregnant. Median maternal age was 28 years and median gestational age was 32 weeks; 36% were non-Hispanic white, 29% non-Hispanic black, and 20% Hispanic. Underlying conditions were present in 35% (n=931), with asthma (n=613; 22.7%) and chronic metabolic disease (n=204; 7.6%) as the most common; 12% (n=299) were current smokers. Vaccination coverage and antiviral receipt varied by season and age [Figures 1 and 2]. Overall, 31% (n=846) were vaccinated and 89% (n=2,408) received antivirals. Five percent (n=132) had intensive care unit admission, 2% (n=52) required mechanical ventilation, 6% (n=165) developed pneumonia and 0.3% (n=9) died; median length of hospital stay was 2 days (IQR 1-3). The most common symptoms at admission included cough (68%) and fever (66%) [Figure 3]. At discharge, most women (70%; n=1865) were still pregnant while 28% (n=758) were no longer pregnant and 2% (n=44) had unknown pregnancy status. Among women who were no longer pregnant at discharge, 96% (n=726) had pregnancies resulting in live births, 3% (n=25) had pregnancies resulting in loss of the fetus or neonate, and 1.0% (n=7) had unknown birth outcome.Figure 1. Vaccination coverage among pregnant women hospitalized with laboratory-confirmed influenza by season and by age group, FluSurv-NET 2010-2019
Figure 2. Antiviral treatment among pregnant women hospitalized with laboratory-confirmed influenza by season and by age group, FluSurv-NET 2010-2019
Figure 3. Symptoms at admission among pregnant women hospitalized with laboratory-confirmed influenza by age group, FluSurv-NET 2010-2019


Conclusion: Over 9 influenza seasons, nearly one-third of women aged 15-44 years and hospitalized with influenza were pregnant. Severe maternal and fetal outcomes were rare. While most women received antivirals, fewer than one-third received current season influenza vaccine.

Presenting Author(s)

• 

  Rachel Holstein, MPH

  Epidemiology and Information Science Fellow
  Centers for Disease Control and Prevention
  Atlanta, GA

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

  Slides Slides and Audio

Co-Author(s)

• FD

  Fatima S. Dawood, MD, MPH

  Medical Epidemiologist
  Centers for Disease Control and Prevention
  Atlanta, Georgia

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• PD

  Pam Daily Kirley, MPH

  Epidemiologist
  California Emerging Infections Program
  Oakland, California

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• RH

  Rachel Herlihy, MD. MPH

  State Epidemiologist
  Colorado Department of Public Health and Environment
  Denver, Colorado

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• KY

  Kim Yousey-Hindes, MPH, CPH

  Epidemiologist 3
  Connecticut Emerging Infections Program
  New Haven, Connecticut

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• EF

  Emily Fawcett, MPH

  Surveillance Officer
  Georgia Emerging Infections Program and Atlanta VA Medical Center
  Decatur, Georgia

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• MM

  Maya Monroe, MPH

  Epidemiologist
  Maryland Department of Health and Mental Hygiene
  Baltimore, Maryland

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• SK

  Sue Kim, MPH

  Epidemiologist
  Michigan Department of Health and Human Services
  Lansing, Michigan

  Disclosure: Council of State and Territorial Epidemiologists (CSTE) (Grant/Research Support)
• 

  Ruth Lynfield, MD

  State Epidemiologist
  Minnesota Department of Health
  St. Paul, Minnesota

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• CM

  Chelsea L. McMullen, MSc-GH

  Respiratory Disease Surveillance Coordinator
  New Mexico Department of Health
  Santa Fe, New Mexico

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• AM

  Alison Muse, MPH

  Epidemiologist
  New York State Department of Health
  Albany, New York

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• LB

  Laurie M. Billing, MPH

  Epidemiologist
  Ohio Department of Health
  Columbus, Ohio

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• MS

  Melissa Sutton, MD, MPH

  Public Health Physician
  Oregon Health Authority
  Portland, Oregon

  Disclosure: CDC funding (Emerging Infections Program) (Grant/Research Support)
• HT

  Helen Talbot, MD, MPH

  Associate Professor
  Vanderbuilt University
  Nashville, Tennessee

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• IR

  Ilene Risk, MPA

  Epidemiology Bureau Manager
  Salt Lake County Health Dept.
  Salt Lake City, Utah

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
• SG

  Shikha Garg, MD, MPH

  Medical Epidemiologist
  Centers for Disease Control and Prevention
  Atlanta, Georgia

  Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.