Hartert Tina V, Neuzil Kathleen M, Shintani Ayumi K, Mitchel Edward F, Snowden Mary S, Wood Lesa B, Dittus Robert S, Griffin Marie R
Department of Medicine, Division of General Internal Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2650, USA.
Am J Obstet Gynecol. 2003 Dec;189(6):1705-12. doi: 10.1016/s0002-9378(03)00857-3.
A population-based assessment of maternal and perinatal morbidity related to respiratory illness during influenza season among pregnant women has not been published. The objectives of this investigation were to describe and quantify the impact of respiratory hospitalization during pregnancy on serious maternal and perinatal morbidity.
A matched cohort study using an administrative database of pregnant women enrolled in the Tennessee Medicaid population to determine pregnancy outcomes associated with respiratory hospitalizations during influenza season. Pregnant women aged 15 to 44 years with a respiratory hospitalization during influenza seasons 1985-1993 were matched by gestational age and presence of comorbidity with pregnant control subjects without a respiratory hospitalization.
During the eight influenza seasons studied, 293 women with singleton pregnancies had respiratory disease hospitalizations (5.1:1000). Women with asthma had high rates of such hospitalization (59.7:1000). Compared with matched controls, women with respiratory hospitalizations had similar modes of delivery, delivery length of stay, and episodes of preterm labor. The prevalence of prematurity and low birth weight among infants born to such women was likewise similar between the two groups.
In this population of pregnant women, those with asthma accounted for half of all respiratory-related hospitalizations during influenza seasons, with 6% of pregnant women with asthma requiring respiratory hospitalization during influenza season, (odds ratio 10.63, 95% CI, 8.18-13.83, compared with women without a medical comorbidity). We detected no significant increase in adverse perinatal outcomes associated with respiratory hospitalizations during influenza season.
尚未发表过基于人群对流感季节孕妇呼吸道疾病相关的孕产妇及围产期发病率的评估。本研究的目的是描述并量化孕期因呼吸道疾病住院对严重孕产妇及围产期发病率的影响。
一项匹配队列研究,利用田纳西州医疗补助人群中孕妇的管理数据库来确定流感季节期间与呼吸道疾病住院相关的妊娠结局。1985 - 1993年流感季节期间因呼吸道疾病住院的15至44岁孕妇,根据孕周和合并症情况与未因呼吸道疾病住院的孕妇对照进行匹配。
在研究的八个流感季节中,293名单胎妊娠妇女因呼吸道疾病住院(5.1/1000)。哮喘患者的此类住院率较高(59.7/1000)。与匹配的对照组相比,因呼吸道疾病住院的妇女在分娩方式、分娩住院时间和早产发作方面相似。两组中此类妇女所生婴儿的早产和低出生体重患病率同样相似。
在这群孕妇中,哮喘患者占流感季节所有呼吸道相关住院病例的一半,6%的哮喘孕妇在流感季节需要因呼吸道疾病住院(优势比10.63,95%可信区间,8.18 - 13.83,与无合并症的妇女相比)。我们未发现流感季节因呼吸道疾病住院与不良围产期结局有显著增加的关联。