Department of Obstetrics and Gynecology, University of California, Los Angeles, California.
Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, Rhode Island.
Am J Perinatol. 2019 Jan;36(1):90-96. doi: 10.1055/s-0038-1666975. Epub 2018 Jul 9.
The objective of this study was to evaluate the negative predictive value (NPV) of a rapid influenza diagnostic test (RIDT) compared with polymerase chain reaction (PCR) in pregnant women.
Retrospective cohort study of pregnant women with a negative RIDT followed by confirmatory PCR for influenza A, H1N1, and B during the influenza seasons from 2012 to 2015.
The NPV of the RIDT was 85.4% (211 of 247), 93.5% (231 of 247), and 97.9% (242 of 247) for influenza A, H1N1, and B, respectively. Antiviral treatment was administered to 47.2% (17 of 36) of women with a false-negative RIDT for influenza A compared with 9.0% (19 of 211) of women with a true-negative RIDT (< 0.001). Patients were more likely to receive antiviral treatment if they were feverish (adjusted odds ratio [aOR]: 6.05, 95% confidence interval [CI]: 1.83-20.03), had cough (aOR: 6.43, 95% CI: 1.06-39.26), dyspnea (aOR: 6.41, 95% CI: 1.63-25.29), or had a subsequently positive PCR (aOR: 9.41, 95% CI: 3.13-28.31).
Up to 14.5% of women with a negative RIDT in pregnancy had positive influenza A by PCR of whom more than half did not receive antiviral treatment.
本研究旨在评估快速流感诊断检测（RIDT）相对于聚合酶链反应（PCR）在孕妇中的阴性预测值（NPV）。
这是一项回顾性队列研究，纳入了在 2012 年至 2015 年流感季节中，RIDT 检测结果为阴性的孕妇，随后对其进行流感 A、H1N1 和 B 的 PCR 检测。
RIDT 对流感 A、H1N1 和 B 的 NPV 分别为 85.4%（211/247）、93.5%（231/247）和 97.9%（242/247）。与 RIDT 检测结果为真阴性的 211 名孕妇（9.0%）相比，RIDT 检测结果为假阴性的 36 名流感 A 孕妇中，有 47.2%（17/36）接受了抗病毒治疗（<0.001）。如果孕妇出现发热（调整后优势比[aOR]：6.05，95%置信区间[CI]：1.83-20.03）、咳嗽（aOR：6.43，95% CI：1.06-39.26）、呼吸困难（aOR：6.41，95% CI：1.63-25.29）或随后 PCR 检测结果为阳性（aOR：9.41，95% CI：3.13-28.31），则更有可能接受抗病毒治疗。
多达 14.5% 的妊娠 RIDT 检测结果为阴性的孕妇，其流感 A 经 PCR 检测结果为阳性，其中超过一半的孕妇未接受抗病毒治疗。
