Flu during pregnancy associated with late-term pregnancy loss, reduced birth weight
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Influenza infection during pregnancy is associated with late-term pregnancy loss and reduced birth weight, according to study findings published in The Lancet Infectious Diseases.
“Influenza vaccination during pregnancy protects women and their infants from influenza but remains underused among pregnant women in many parts of the world,” Fatimah S. Dawood, MD, a pediatrician and medical officer in the CDC’s Influenza Division, told Healio. “With this study, we aimed to quantify the risk of antenatal influenza during influenza season in three countries and examine the effect of influenza during pregnancy on pregnancy and infant outcomes to provide policymakers, health care workers and pregnant women with information to make decisions about influenza vaccination.”
Dawood and colleagues enrolled pregnant women in India, Peru and Thailand in a prospective cohort study. The women were aged 18 years or older with an expected delivery date 8 weeks or more into the 2017 and 2018 influenza seasons.
The researchers contacted women twice weekly until the end of pregnancy to identify illnesses and collected midturbinate nasal swabs from symptomatic women for real-time PCR (RT-PCR) testing. They then assessed the association of antenatal influenza with preterm birth, late pregnancy loss, small for gestational age (SGA) and birth weight of term singleton infants.
In total, 11,277 women were enrolled in the study between March 13, 2017, and Aug. 3, 2018. Of these, 1,474 (13%) were vaccinated against influenza. According to the study, 310 participants (3%) had influenza 270 had influenza A and 40 influenza B.
The study demonstrated that antenatal influenza was not associated with preterm birth (adjusted HR =1.4; 95% CI, 0.9-2) or having an SGA infant (adjusted RR = 1; 95% CI, 0.8-1.3) but was associated with late pregnancy loss (aHR =10.7; 95% CI, 4.3-27) and reduction in mean birth weight of term, singleton infants (–55.3 g; 95% CI, –109.3 to –1.4).
Dawood said pregnant women’s risk for influenza increased for each month that a woman was pregnant during the influenza season, and that these findings support the added value of influenza vaccination for pregnant women both to prevent influenza in mothers and their infants and reduce the risk for negative influenza-associated pregnancy outcomes.
“Influenza infection during pregnancy may increase a woman’s risk of some negative pregnancy outcomes,” Dawood said. “A flu vaccine is the best way to protect pregnant women and their infants from the flu.”
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