Influenza-like illness in pregnant women during summertime: clinical, epidemiological and microbiological features

Paño‐Pardo, José Ramón; Martínez-Sánchez, Nuria; Martín-Quirós, Alejandro; Romero-Gómez, María Pilar; Muñoz-Muñiz, M.; Sánchez-Pastor, Margarita; Ruiz, Guillermo García-Contreras; San-José, B.; Prados, Mónica Cuervo; Mora-Rillo, Marta; Rico-Nieto, Alicia; Arribas, José Ramón

doi:10.1007/s10096-011-1248-4

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…These results showed that during the flu‐pandemic 2009–2010, non‐influenza respiratory viruses were recovered in 23% of pregnant women presenting with influenza syndrome while influenza A virus itself was detected in only 42% and oseltamivir prescribed in 88%. Interestingly, the diversity of viruses observed and their distribution were similar to those reported in a series of 45 pregnant women in Spain [Paño‐Pardo et al, ]. In addition, the comparison of these results with those of a British team [Gaunt et al, ] showed that the profile of respiratory viruses in pregnant women with influenza‐like illness was closer to the profile of viruses causing important disease burden in immunocompromised patients compared to non‐immunosuppressed adults.…”

Section: Discussionsupporting

confidence: 82%

Rhinoviruses as an underestimated cause of influenza‐like illness in pregnancy during the 2009–2010 influenza pandemic

Pilorgé

Chartier

Méritet

et al. 2013

Journal of Medical Virology

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During the 2009-2010 influenza pandemic, pregnant women were identified at high risk for severe infection. In case of influenza-like illness they were systematically treated with oseltamivir. When performed, virological diagnosis showed that some of these women were not influenza-infected. The objectives of the study were to identify viruses which could induce an influenza-like illness in pregnant women during the 2009-2010 pandemic, then to establish possible links between detected viruses and symptoms, and then characterize human rhinoviruses (HRV) strains detected in some samples. Nasal swabs from 78 pregnant women presenting with influenza-like illness and previously tested for influenza virus by RT-PCR in 2009-2010 were further assayed by multiplex RespiFinder assay and bocavirus PCR to search for 13 other viruses. Genotyping of HRV strains was carried out using partial genomic sequencing in the VP4/VP2 region. Influenza A virus infection was confirmed in 33 women (42%). Non-influenza viruses were detected in 18 additional cases (23%). Rhinoviruses were the most numerous (13%) and belonged to 9 different genotypes distributed between the 3 genogroups. When comparing symptoms observed in influenza-infected women and women infected by other viruses, shivers were more frequent in the former group (P=0.02), and expectorations in the latter (P=0.03). During the influenza pandemic 2009-2010, non-influenza viruses and mostly rhinoviruses were an underestimated cause of influenza-like illness in pregnant women. Viral diagnosis should help to stop empiric oseltamivir therapy in influenza-negative patients and antibiotic treatment in patients infected with a non-influenza virus.

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Section: Discussionsupporting

confidence: 82%

Rhinoviruses as an underestimated cause of influenza‐like illness in pregnancy during the 2009–2010 influenza pandemic

Pilorgé

Chartier

Méritet

et al. 2013

Journal of Medical Virology

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“…The viral SARI rate among PW was higher than NPW, consistent with the findings from the state of Paraná. Influenza was the most frequent among the investigated viruses in PW, followed by hRV, in similar profile as described previously [5,14]. In accordance with to Azziz-Baumgartner et al (2021) [15], we did not identify any cases of hAdV among PW.…”

Section: Discussionsupporting

confidence: 92%

“A Retrospective Cross-Sectional Analysis of Viral Sari in Pregnant Women in Southern Brazil”

Lissa,

Lapinski,

Graf

et al. 2024

Preprint

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Pregnant women (PW) are at a higher risk of diseases and hospitalization from viral respiratory infections, specially influenza, due to cardiopulmonary and immunological changes. This study assessed the impact of viral respiratory infections on PW hospitalized with severe acute respiratory infection (SARI). It´s a cross-sectional study with 42 PW and 85 non-pregnant women (NPW) admitted with SARI to two tertiary hospital between January 2015 and December 2019. The rate of virus prevalence, SARI hospitalization, length of hospital stay, oxygen supplementation, intensive care unit (ICU) admission, and death were comparable between PW and NPW. Multivariate analysis showed that PW had a higher rate of viral SARI hospitalizations (OR = 2.37; 95% CI =1.02 - 5.48) compared to NPW, with influenza virus being the most prevalent (aOR =7.58; 95% CI =1.53 - 37.66). Length of hospital stay (aOR = 0.83; 95% CI = 0.73 – 0.95) and admission to the ICU (aOR=0.028; 95% CI=0.004 - 0.25) were lower in PW compared to hospitalized NPW. Respiratory viruses had a greater impact on the frequency of SARI in the group of PW. Although PW had a higher rate of influenza SARI, they had a better outcome than NPW due to the treatment they received.

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“…The influenza test was generally performed using specific PCR, but in five cases, multiplex PCR was performed, detecting two positive cases for rhinoviruses. Two retrospective studies conducted during the 2009–2010 flu pandemic found in pregnant women with influenza-like symptoms, non-influenza respiratory viruses rates of 23 %, and influenza H1N1 rates between 31 and 42 %, similar to our results [ 10 , 11 ]. The multiplex PCR was not used on a routine basis because it is expensive and time-consuming, although this strategy could possibly avoid use of antibiotics and hospitalizations.…”

Section: Discussionsupporting

confidence: 91%

Causes and consequences of fever during pregnancy: A retrospective study in a gynaecological emergency department

Egloff

Sibiude

Couffignal

et al. 2020

Journal of Gynecology Obstetrics and Human Reproduction

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Objective Fever is a very common reason for emergency consultation during pregnancy, and may be associated with maternal, obstetrical and/or fetal adverse outcomes. The aim of this study was to determine the etiologies and to analyze the maternal or fetal complications of fever in pregnancy. Study design A retrospective single center study including all patients who consulted for fever above 38 °C during pregnancy in the gynecological emergency ward from August 2016 to July 2017. Results A total of 100 pregnant women who consulted for fever were included. The etiologies were common viral infections (37 %), influenza (21 %), pyelonephritis (11 %), viral gastroenteritis (6%), chorioamnionitis (5%), other (5%). The etiology was unknown for 15 %. Fever was confirmed during consultation in 45/100 patients (45 %). Among patients with confirmed fever, 21/45 (47 %) were hospitalized with a median stay of 3 days [IQR 2–4] and 10/45(22 %) developed fetal or maternal complications. Probabilistic antibiotics were delivered for 34/45, 76 % patients. Only 14/45, 31 % had confirmed bacterial infections. Of the 32 patients with confirmed fever who had no etiologic diagnosis at the initial work-up in the emergency room, 19/32, 59 % received presumptive treatment with amoxicillin against Listeria monocytogenes . None had confirmed listeriosis, and all were probably common viral infections. Among all patients, the complications rate was 13 % and 22 % in the subgroup with fever confirmed at presentation. Conclusions This study quantifies the main etiologies and complications of fever during pregnancy. A challenge is to reduce excessive antibiotic use by improving rapid diagnosis of bacterial and viral infections. Prospective studies are needed to target patients at risk of complications in an optimal way and to study new management strategies.

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Influenza-like illness in pregnant women during summertime: clinical, epidemiological and microbiological features

Cited by 6 publications

References 9 publications

Rhinoviruses as an underestimated cause of influenza‐like illness in pregnancy during the 2009–2010 influenza pandemic

Rhinoviruses as an underestimated cause of influenza‐like illness in pregnancy during the 2009–2010 influenza pandemic

“A Retrospective Cross-Sectional Analysis of Viral Sari in Pregnant Women in Southern Brazil”

Causes and consequences of fever during pregnancy: A retrospective study in a gynaecological emergency department

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