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Early antiviral therapy for pregnant women with flu reduces hospital durations
New study results suggest that pregnant women hospitalized with influenza may spend less time in the hospital when treated promptly with an antiviral drug, rather than days later.
Early treatment with Tamiflu (oseltamivir, Roche) may be particularly beneficial for expectant mothers with severe cases of influenza, shortening their hospital stay by about 5 days, according to the findings published in The Journal of Infectious Diseases.
Sandra S. Chaves
“The earlier you treat, the better chances you have to modify the course of the illness,” researcher Sandra S. Chaves, MD, MSc, influenza program director with the CDC, said in a news release.
Chaves and colleagues used data culled from a 14-state influenza surveillance network covering 240 hospitals serving approximately 27 million people. They focused on 865 pregnant women aged 15 to 44 years hospitalized within 2 days of an influenza-positive test result during four influenza seasons from 2010 to 2014. The median age of the women was 27 years, and 57% were in their third trimester. The researchers adjusted the analysis for underlying conditions, influenza vaccination and trimester.
About 7% of the patients were considered to have severe illness, and of these four died. Although those who died received antivirals, three patients were treated after 2 days. Only one of the women had received a vaccine for the season.
Among the women with severe illness treated within 2 days of symptom onset, the median length of stay was 2.2 days, compared with 7.8 days for those treated after 2 days (P = .03). Women with nonsevere illness treated within 2 days spent a median of 2.4 days in the hospital vs. 3.1 days when treated later (P < .01).
The researchers, in line with the CDC, recommend treating pregnant women suspected of having influenza as soon as possible without waiting for laboratory results.
Vaccination is warranted in pregnant women, as influenza is associated with maternal and infant morbidity, the researchers said. However, only 26% of women participating in the study received vaccination, and women with severe influenza were less likely to have received a vaccine than those who were not as sick.
“All pregnant women should receive annual influenza vaccination to prevent influenza and associated complications for themselves and their infants,” the researchers wrote.
In a related commentary, Alan T.N. Tita, MD, PhD, and William W. Andrews, PhD, MD, both of the University of Alabama at Birmingham, said the accumulating evidence of fetal benefit and safety shows influenza vaccinations for pregnant and postpartum women should be a public health priority.
“Prompt initiation of antiviral therapy if infection occurs, preferably within 2 days of suspected or confirmed influenza infection, is encouraged,” Tita and Andrews wrote. “Additional evaluation to assess fetal safety and to determine whether or not there is ongoing benefit when therapy is initiated after 2 days of symptoms are reasonable goals.” – by Gerard Gallagher
Disclosure: The researchers report no relevant financial disclosures.