MMWR Morb Mortal Wkly Rep. 2024 Oct 31;73(43):958-964. doi: 10.15585/mmwr.mm7343a1.
Pregnancy is associated with increased risk for severe illness and complications associated with influenza infection. Insufficient knowledge about the risk for influenza among pregnant women and their health care providers in China is an important barrier to increasing influenza vaccination coverage and treating influenza and its complications among pregnant women. Improved influenza incidence estimates might promote wider vaccine acceptance and higher vaccination coverage. In Suzhou, active population-based surveillance during October 2018-September 2023 estimated that the annual rate of hospitalization for acute respiratory or febrile illness (ARFI) among women who were pregnant or <2 weeks postpartum was 11.1 per 1,000 live births; the annual rate of laboratory-confirmed influenza-associated ARFI (influenza ARFI) hospitalization in this group was 2.1 per 1,000 live births. A majority of hospitalized pregnant or early postpartum patients with ARFI (82.6%; 2,588 of 3,133) or influenza ARFI (85.5%; 423 of 495) were admitted to obstetrics wards rather than respiratory medicine wards. Only one (0.03%) pregnant or postpartum ARFI patient had received influenza vaccination, and 31.3% of pregnant or postpartum women hospitalized for influenza ARFI received antiviral treatment; the lowest percentage of hospitalized women with influenza ARFI who received antiviral treatment was among women admitted to obstetrics and gynecology wards (29.6% and 23.1%, respectively), compared with 54.1% of those admitted to a respiratory medicine ward. These findings highlight the risk for influenza and its associated complications among pregnant and postpartum women, the low rates of influenza vaccination among pregnant women, and of antiviral treatment of women with ARFI admitted to obstetrics and gynecology wards. Increasing awareness of the prevalence of influenza ARFI among pregnant women, the use of empiric antiviral treatment for ARFI, and the infection control in obstetrics wards during influenza seasons might help reduce influenza-associated morbidity among pregnant and postpartum women.
妊娠与流感感染相关的严重疾病和并发症风险增加有关。中国的孕妇及其医疗保健提供者对流感风险的认识不足，是增加流感疫苗接种覆盖率以及治疗孕妇流感及其并发症的重要障碍。改进流感发病率估计可能会促进更广泛的疫苗接受度和更高的疫苗接种率。在苏州，2018 年 10 月至 2023 年 9 月期间进行的基于人群的主动监测估计，妊娠或产后<2 周的女性因急性呼吸道或发热疾病（ARFI）住院的年发生率为每 1000 例活产 11.1 例；该组中经实验室确诊的流感相关 ARFI（流感 ARFI）住院年发生率为每 1000 例活产 2.1 例。大多数因 ARFI（82.6%，3133 例中的 2588 例）或流感 ARFI（85.5%，495 例中的 423 例）住院的妊娠或早产后患者被收治在妇产科病房，而非呼吸内科病房。只有 1 例（0.03%）妊娠或产后 ARFI 患者接受了流感疫苗接种，31.3%的流感 ARFI 住院妊娠或产后女性接受了抗病毒治疗；在接受流感 ARFI 治疗的住院女性中，接受抗病毒治疗的比例最低的是妇产科病房（分别为 29.6%和 23.1%），而呼吸内科病房为 54.1%。这些发现突出了妊娠和产后女性患流感及其相关并发症的风险、孕妇中流感疫苗接种率低以及妇产科病房 ARFI 住院女性接受抗病毒治疗的比例低。提高孕妇中流感 ARFI 的流行率意识、对 ARFI 采用经验性抗病毒治疗以及在流感季节加强妇产科病房的感染控制，可能有助于降低妊娠和产后女性的流感相关发病率。
