An international cohort study of birth outcomes associated with hospitalized acute respiratory infection during pregnancy

Regan, Annette K.; Feldman, Becca; Azziz‐Baumgartner, Eduardo; Naleway, Allison L.; Williams, Jennifer; Wyant, Brandy E; Simmonds, Kim; Effler, Paul V.; Booth, Stephanie; Ball, Sarah; Katz, Mark A.; Fink, Rebecca V.; Thompson, Mark G.; Chung, Hannah; Kwong, Jeffrey C.; Fell, Deshayne B.

doi:10.1016/j.jinf.2020.03.057

Cited by 19 publications

(28 citation statements)

References 34 publications

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“…These associations remained significant when adjusted for confounders by multiple logistic regression. Our findings agree with 2 recently published studies (7,8) showing an association of SARI, including influenza, among pregnant women with low birthweights. Pregnant mothers who had SARI were more likely to require medical assistance during labor than those who did not have SARI.…”

Section: Discussionsupporting

confidence: 93%

Perinatal Outcomes of Asynchronous Influenza Vaccination, Ceará, Brazil, 2013–2018

Filho¹,

Francisco²,

Lima³

et al. 2021

Emerg. Infect. Dis.

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R espiratory infections are a leading cause of disease and death worldwide (1,2), especially among young children and older adults. However, the adverse effects of respiratory infections on pregnant women and fetal development are understudied, particularly in low-and middle-income countries. Respiratory infections in pregnant women can negatively affect birth outcomes, early childhood growth, and neurodevelopment (3).Infl uenza epidemics are associated with excess rates of pneumonia, related hospitalizations, and death (4). Pregnant women and their infants are at heightened risk for severe infl uenza (5,6). In 2020, Regan et al. ( 7) conducted a retrospective cohort study of pregnant women from Australia, Canada, Israel, and the United States; results showed hospitalizations for acute respiratory or febrile illnesses were associated with low birthweight but not small-for-gestational-age births. A prospective cohort study of pregnant women in India, Peru, and Thailand showed infl uenza during pregnancy is associated with late pregnancy loss and reduced mean birthweight (8). A meta-analysis ( 9) found that during the 2009 pandemic of infl uenza A(H1N1)pdm09, the risk for infl uenza hospitalization was 2-fold higher for women who were pregnant than those who were not. Children born to mothers infected during pregnancy face potential adverse consequences for physical and neurocognitive development. These consequences resemble the growth and developmental challenges described in children born to undernourished mothers in global settings with high rates of pneumonia and diarrhea (10-14).In 2018, Almeida et al. (15) revealed that 12 of 27 states in Brazil demonstrate annual seasonal infl uenza activity. States along the coast generally have seasonal infl uenza patterns, whereas states in the North and Central West regions exhibit no readily identifi able seasonality, probably because landlocked states might have more complex and diffi cult to detect transmission patterns. In the semiarid state of Ceará, which has a population of ≈8.8 million persons, peak seasonal infl uenza

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Section: Discussionsupporting

confidence: 93%

Perinatal Outcomes of Asynchronous Influenza Vaccination, Ceará, Brazil, 2013–2018

Filho¹,

Francisco²,

Lima³

et al. 2021

Emerg. Infect. Dis.

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“…Marta Nunes (University of the Witwatersrand, South Africa) reported on how maternal immunization programs can be effectively implemented in LMICs, using the example of influenza vaccination campaigns targeted at pregnant women at antenatal clinics in South Africa. Annette Regan's (Texas A&M University, USA) findings from the PREVENT network project emphasized the potential impact of influenza infection on pregnancy and the newborn (8). Although influenza infection during pregnancy was not often diagnosed in this international cohort, acute influenza infection during pregnancy was associated with an increased risk of preterm birth and low birth weight.…”

Section: Protecting Newborns and Infants Through Maternal Immunizationmentioning

confidence: 91%

“…Hospital records were combined with laboratory testing data and birth records to identify acute respiratory or febrile illness-related admissions during pregnancy and infant outcomes of preterm birth and low birthweight. Such studies demonstrate the potential perinatal benefits of preventing maternal severe respiratory disease, such as via influenza vaccination (8). Different approaches have successfully been used for these data linkage studies, including (i) a distributed data model in which autonomous software on a centralized secure server accesses site-specific patient-level data to enable a single combined analysis and (ii) a common data model in which there is harmonization of protocols to standardize variable definitions and statistical analysis, with separate site-specific analyses enabling final meta-analysis of site-specific estimates (17,18).…”

Section: Protecting Newborns and Infants Through Maternal Immunizationmentioning

confidence: 96%

The Fifth International Neonatal and Maternal Immunization Symposium (INMIS 2019): Securing Protection for the Next Generation

Sadarangani

Kollmann

Bjornson

et al. 2021

mSphere

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Despite significant progress in reaching some milestones of the United Nations Sustainable Development Goals, neonatal and early infant morbidity and mortality remain high, and maternal health remains suboptimal in many countries. Novel and improved preventative strategies with the potential to benefit pregnant women and their infants are needed, with maternal and neonatal immunization representing effective approaches. Experts from immunology, vaccinology, infectious diseases, clinicians, industry, public health, and vaccine-related social sciences convened at the 5th International Neonatal and Maternal Immunization Symposium (INMIS) in Vancouver, Canada, from 15 to 17 September 2019. We critically evaluated the lessons learned from recent clinical studies, presented cutting-edge scientific progress in maternal and neonatal immunology and vaccine development, and discussed maternal and neonatal immunization in the broader context of infectious disease epidemiology and public health. Focusing on practical aspects of research and implementation, we also discussed the safety, awareness, and perception of maternal immunization as an existing strategy to address the need to improve maternal and neonatal health worldwide. The symposium provided a comprehensive scientific and practical primer as well as an update for all those with an interest in maternal and neonatal infection, immunity, and vaccination. The summary presented here provides an update of the current status of progress in maternal and neonatal immunization.

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“…Influenza immunization programs expanded to include pregnant women following the 2012 WHO SAGE recommendations, 38 given increased risk of severe maternal disease and mortality as well as increased risk of pregnancy loss, preterm birth, and low birthweight birth. 39,40 Evidence indicates that maternal influenza immunization prevents influenza illnesses in pregnant women and their infants, [41][42][43] although data about severe illness prevention in LMICs are limited. 44,45 The PAHO and partners have conducted operational research studies in LAC to define optimal strategies to improve vaccination of pregnant women (and health workers).…”

Section: Strengthening Influenza Surveillance Monitoring and Data Utilizationmentioning

confidence: 99%

Seasonal Influenza Prevention and Control Progress in Latin America and the Caribbean in the Context of the Global Influenza Strategy and the COVID-19 Pandemic

Vicari

Olson

Vilajeliu

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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Each year in Latin America and the Caribbean, seasonal influenza is associated with an estimated 36,500 respiratory deaths and 400,000 hospitalizations. Since the 2009 influenza A(H1N1) pandemic, the Region has made significant advances in the prevention and control of seasonal influenza, including improved surveillance systems, burden estimates, and vaccination of at-risk groups. The Global Influenza Strategy 2019–2030 provides a framework to strengthen these advances. Against the backdrop of this new framework, the University of Colorado convened in October 2020 its Immunization Advisory Group of Experts to review and discuss current surveillance, prevention, and control strategies for seasonal influenza in Latin America and the Caribbean, also in the context of the COVID-19 pandemic. This review identified five areas for action and made recommendations specific to each area. The Region should continue its efforts to strengthen surveillance and impact evaluations. Existing data on disease burden, seasonality patterns, and vaccination effectiveness should be used to inform decision-making at the country level as well as advocacy efforts for programmatic resources. Regional and country strategic plans should be prepared and include specific targets for 2030. Existing investments in influenza prevention and control, including for immunization programs, should be optimized. Finally, regional partnerships, such as the regional networks for syndromic surveillance and vaccine effectiveness evaluation (SARInet and REVELAC-i), should continue to play a critical role in continuous learning and standardization by sharing experiences and best practices among countries.

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An international cohort study of birth outcomes associated with hospitalized acute respiratory infection during pregnancy

Cited by 19 publications

References 34 publications

Perinatal Outcomes of Asynchronous Influenza Vaccination, Ceará, Brazil, 2013–2018

Perinatal Outcomes of Asynchronous Influenza Vaccination, Ceará, Brazil, 2013–2018

The Fifth International Neonatal and Maternal Immunization Symposium (INMIS 2019): Securing Protection for the Next Generation

Seasonal Influenza Prevention and Control Progress in Latin America and the Caribbean in the Context of the Global Influenza Strategy and the COVID-19 Pandemic

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