Murtough Katie L, Power Michael L, Schulkin Jay
Research Department, American College of Obstetricians and Gynecologists , Washington, DC.
J Womens Health (Larchmt). 2015 Oct;24(10):849-54. doi: 10.1089/jwh.2014.5178. Epub 2015 Jul 8.
Pregnant women are at increased risk for complications associated with influenza. Influenza vaccination during pregnancy helps protect both pregnant women and infants less than 6 months of age from contracting the flu. This study investigated influenza prevention and treatment practices of obstetrician-gynecologists (ob-gyns) during the influenza season immediately following the 2009-2010 H1N1 season.
In 2011, surveys were sent to two groups of Fellows of the American College of Obstetricians and Gynecologists. Group 1 was 907 ob-gyns who responded to our previous survey on practice and knowledge of influenza vaccination, diagnosis, and treatment during the 2009-2010 H1N1 influenza pandemic. Group 2 was 2,293 new recipients randomly selected from the American College of Obstetricians and Gynecologists database. Data were analyzed in 2013.
A high proportion of pregnant patients were reported to be vaccinated against influenza (71.7%); however, the data suggest that in general preventative practices decreased between the 2009-2010 H1N1 season and 2010-2011 season. A higher proportion of women eligible for Medicaid in a practice was associated with a lower estimate of vaccination rate. Ob-gyns with more than 20 years of practice were more likely to be concerned about the risks of antivirals and less likely to routinely prescribe them.
Ob-gyns may be overestimating the proportion of pregnant women being vaccinated. The gains in vaccination and influenza prevention practices from the H1N1 pandemic have not been completely retained. Discrepancies in the use of anti-virals to treat suspected or confirmed influenza in pregnant patients exist and need to be addressed.
孕妇出现与流感相关并发症的风险增加。孕期接种流感疫苗有助于保护孕妇和6个月以下婴儿免受流感侵袭。本研究调查了2009 - 2010年H1N1流感季之后的流感季节期间妇产科医生的流感预防和治疗实践。
2011年,向两组美国妇产科医师学会会员发送了调查问卷。第一组是907名妇产科医生,他们曾回复过我们之前关于2009 - 2010年H1N1流感大流行期间流感疫苗接种、诊断和治疗的实践与知识的调查。第二组是从美国妇产科医师学会数据库中随机选取的2293名新会员。2013年对数据进行了分析。
据报告,很大比例的孕妇接种了流感疫苗(71.7%);然而,数据表明,总体而言,预防措施在2009 - 2010年H1N1流感季和2010 - 2011年流感季之间有所减少。在一个医疗机构中,符合医疗补助资格的女性比例较高与较低的疫苗接种率估计值相关。有超过20年从业经验的妇产科医生更有可能担心抗病毒药物的风险,且不太可能常规开具此类药物。
妇产科医生可能高估了接种疫苗的孕妇比例。H1N1流感大流行期间在疫苗接种和流感预防实践方面取得的成果并未完全得以保持。在使用抗病毒药物治疗疑似或确诊流感的孕妇方面存在差异,需要加以解决。