Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Abt Associates Inc, Atlanta, Georgia, USA.
Influenza Other Respir Viruses. 2023 Jan;17(1):e13063. doi: 10.1111/irv.13063. Epub 2022 Oct 28.
Despite the World Health Organization (WHO) recommendation that pregnant women be prioritised for seasonal influenza vaccination, coverage in the Western Pacific Region remains low. Our goal was to provide additional data for the Western Pacific Region about the value of maternal influenza vaccination to pregnant women and their families.
We conducted a 16-year retrospective cohort to evaluate risks associated with influenza-associated maternal acute respiratory infection (ARI) in New Zealand. ARI hospitalisations during the May to September influenza season were identified using select ICD-10-AM primary and secondary discharge codes from chapter J00-J99 (diseases of the respiratory system). Cox proportional hazards models were used to calculate crude and adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).
We identified 822,391 pregnancies among New Zealand residents between 2003 and 2018; 5095 (0.6%) had ≥1 associated ARI hospitalisation during the influenza season; these pregnancies were at greater risk of preterm birth (aHR 1.50, 95% CI 1.39-1.61) and low birthweight (aHR 1.64, 95% CI 1.51-1.79) than pregnancies without such hospitalisations. We did not find an association between maternal ARI hospitalisation and fetal death (aHR 0.96, 95% CI 0.69-1.34) during the influenza season. Maternal influenza vaccination was associated with reduced risk of preterm birth (aHR 0.79, 95% CI 0.77-0.82), low birthweight (aHR 0.87, 95% CI 0.83-0.90) and fetal death (aHR 0.50%, 95% CI 0.44-0.57).
In this population-based cohort, being hospitalised for an ARI during the influenza season while pregnant was a risk factor for delivering a preterm or a low birthweight infant and vaccination reduced this risk.
尽管世界卫生组织（WHO）建议孕妇优先接种季节性流感疫苗，但西太平洋地区的覆盖率仍然很低。我们的目标是为西太平洋地区提供更多关于孕妇流感疫苗对孕妇及其家庭价值的相关数据。
我们进行了一项为期 16 年的回顾性队列研究，以评估新西兰孕妇与流感相关的急性呼吸道感染（ARI）相关风险。使用 J00-J99 章（呼吸系统疾病）中选择的 ICD-10-AM 主要和次要出院代码，确定 5 月至 9 月流感季节的 ARI 住院情况。使用 Cox 比例风险模型计算粗和调整后的危险比（aHR）和 95%置信区间（CI）。
我们在 2003 年至 2018 年间确定了 822391 例新西兰居民妊娠；5095 例（0.6%）在流感季节至少有 1 次相关 ARI 住院；这些妊娠早产（aHR 1.50，95%CI 1.39-1.61）和低出生体重（aHR 1.64，95%CI 1.51-1.79）的风险高于无此类住院的妊娠。我们没有发现流感季节孕妇 ARI 住院与胎儿死亡（aHR 0.96，95%CI 0.69-1.34）之间存在关联。孕妇流感疫苗接种与早产（aHR 0.79，95%CI 0.77-0.82）、低出生体重（aHR 0.87，95%CI 0.83-0.90）和胎儿死亡（aHR 0.50%，95%CI 0.44-0.57）的风险降低相关。
在这项基于人群的队列研究中，流感季节因 ARI 住院的孕妇是早产或低出生体重婴儿的危险因素，而疫苗接种降低了这种风险。
