孕妇阴性快速流感诊断检测的结果。

Outcomes of a Negative Rapid Influenza Diagnostic Test in Pregnant Women.

机构信息

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.

出版信息

Am J Perinatol. 2019 Jan;36(1):90-96. doi: 10.1055/s-0038-1666975. Epub 2018 Jul 9.

DOI:10.1055/s-0038-1666975

PMID:29986345

Abstract

OBJECTIVE

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.

STUDY DESIGN

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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）。

研究设计

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。

结果

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。