Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis
Background: WHO identifies pregnant women to be at increased risk for severe outcomes from influenza virus infections and recommends that they be prioritized for influenza vaccination. The evidence supporting this, however, is inconsistent. Ecologic studies in particular suggest more severe outcomes...
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| Format: | Article |
| Status: | Published version |
| Publication date: | 2019 |
| Country: | España |
| Institution: | Universidad de Barcelona |
| Repository: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/145341 |
| Online Access: | https://hdl.handle.net/2445/145341 |
| Access Level: | Open access |
| Keyword: | Embarassades Influenzavirus Pregnant women Influenza viruses |
| _version_ | 1878738168310661120 |
|---|---|
| author | Mertz, Dominik |
| author2 | Ka-Fung Lo, Calvin Lytvyn, Lyubov Ortiz, Justin R. Loeb, Mark Carratalà, Jordi Cillóniz, Catia Torres Martí, Antoni FLURISK-INVESTIGATORS |
| author2_role | author author author author author author author author |
| author_browse | Carratalà, Jordi Cillóniz, Catia FLURISK-INVESTIGATORS Ka-Fung Lo, Calvin Loeb, Mark Lytvyn, Lyubov Mertz, Dominik Ortiz, Justin R. Torres Martí, Antoni |
| author_facet | Mertz, Dominik Ka-Fung Lo, Calvin Lytvyn, Lyubov Ortiz, Justin R. Loeb, Mark Carratalà, Jordi Cillóniz, Catia Torres Martí, Antoni FLURISK-INVESTIGATORS |
| author_role | author |
| collection | Dipòsit Digital de la UB |
| description | Background: WHO identifies pregnant women to be at increased risk for severe outcomes from influenza virus infections and recommends that they be prioritized for influenza vaccination. The evidence supporting this, however, is inconsistent. Ecologic studies in particular suggest more severe outcomes from influenza infection during pregnancy than studies based on individual patient data. Individual studies however may be underpowered and, as reported in a previous systematic review, confounding factors could not be adjusted for. We therefore conducted an individual participant data meta-analysis to assess the risk for severe outcomes of influenza infection in pregnant women while adjusting for other prognostic factors. Methods: We contacted authors of studies included in a recently published systematic review. We pooled the individual participant data of women of reproductive age and laboratory confirmation of influenza virus infection. We used a generalized linear mixed model and reported odds ratios (OR) and 95% confidence intervals (CI). Results: A total of 33 datasets with data on 186,656 individuals were available, including 36,498 eligible women of reproductive age and known pregnancy status. In the multivariable model, pregnancy was associated with a 7 times higher risk of hospital admission (OR 6.80, 95%CI 6.02–7.68), among patients receiving medical care as in- or outpatients, pregnancy was associated with a lower risk of admission to intensive care units (ICU; OR 0.57, 95%CI 0.48–0.69), and was not significantly associated with death (OR 1.00, 95%CI 0.75–1.34). Conclusions: Our study found a higher risk of influenza associated hospitalization among pregnant women as compared to non-pregnant women. We did not find a higher mortality rate or higher likelihood of ICU admission among pregnant women who sought medical care. However, this study did not address whether a true community based cohort of pregnant women is at higher risk of influenza associated complications. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_aaa75ca2273a4ed73b5c3dfee199e46d |
| institution | Universidad de Barcelona |
| instname_str | Universidad de Barcelona |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:diposit.ub.edu:2445/145341 |
| publishDate | 2019 |
| publishDateSort | 2019 |
| publisher | BioMed Central |
| publisherStr | BioMed Central |
| reponame_str | Dipòsit Digital de la UB |
| spelling | Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis Mertz, Dominik Ka-Fung Lo, Calvin Lytvyn, Lyubov Ortiz, Justin R. Loeb, Mark Carratalà, Jordi Cillóniz, Catia Torres Martí, Antoni FLURISK-INVESTIGATORS Embarassades Influenzavirus Pregnant women Influenza viruses Background: WHO identifies pregnant women to be at increased risk for severe outcomes from influenza virus infections and recommends that they be prioritized for influenza vaccination. The evidence supporting this, however, is inconsistent. Ecologic studies in particular suggest more severe outcomes from influenza infection during pregnancy than studies based on individual patient data. Individual studies however may be underpowered and, as reported in a previous systematic review, confounding factors could not be adjusted for. We therefore conducted an individual participant data meta-analysis to assess the risk for severe outcomes of influenza infection in pregnant women while adjusting for other prognostic factors. Methods: We contacted authors of studies included in a recently published systematic review. We pooled the individual participant data of women of reproductive age and laboratory confirmation of influenza virus infection. We used a generalized linear mixed model and reported odds ratios (OR) and 95% confidence intervals (CI). Results: A total of 33 datasets with data on 186,656 individuals were available, including 36,498 eligible women of reproductive age and known pregnancy status. In the multivariable model, pregnancy was associated with a 7 times higher risk of hospital admission (OR 6.80, 95%CI 6.02–7.68), among patients receiving medical care as in- or outpatients, pregnancy was associated with a lower risk of admission to intensive care units (ICU; OR 0.57, 95%CI 0.48–0.69), and was not significantly associated with death (OR 1.00, 95%CI 0.75–1.34). Conclusions: Our study found a higher risk of influenza associated hospitalization among pregnant women as compared to non-pregnant women. We did not find a higher mortality rate or higher likelihood of ICU admission among pregnant women who sought medical care. However, this study did not address whether a true community based cohort of pregnant women is at higher risk of influenza associated complications. BioMed Central https://hdl.handle.net/2445/145341 |
| spellingShingle | Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis Mertz, Dominik Embarassades Influenzavirus Pregnant women Influenza viruses |
| status_str | publishedVersion |
| title | Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis |
| title_full | Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis |
| title_fullStr | Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis |
| title_full_unstemmed | Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis |
| title_short | Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis |
| title_sort | Pregnancy as a risk factor for severe influenza infection: an individual participant data meta-analysis |
| topic | Embarassades Influenzavirus Pregnant women Influenza viruses |
| topic_facet | Embarassades Influenzavirus Pregnant women Influenza viruses |
| url | https://hdl.handle.net/2445/145341 |