H1N1流感大流行增加胎儿死亡率
- ①纳入挪威2006-2013年数据库中41万余名孕妇数据，记录流感样疾病（ILI）与2009-2010年H1N1大流行期间的H1N1确诊情况；
- ②共有2510例胎儿发生死亡（包括流产和死产）；
- ③在普通季节性流感期间的ILI与胎儿死亡率之间不存在统计学关联，无论是在孕早期还是孕中晚期；
- ④然而H1N1流行期间，ILI使死胎风险增加1.75倍；
- ⑤尤其在孕早期ILI使死胎风险增加2.28倍，而孕中/晚期的作用无统计学意义；
- ⑥H1N1大流行较普通季节性流感对母婴健康的危害更大。
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该研究通过分析数据库资料，暂无证据表明孕中/晚期流感会增加死产风险，而孕早期的H1N1感染会使得死胎风险增加。该研究强调了H1N1流感大流行对母婴健康的影响，以及孕早期预防流感的重要性。
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Seasonal and pandemic influenza during pregnancy and risk of fetal death: A Norwegian registry-based cohort study
妊娠期经历季节性流感和流感大流行与胎儿死亡风险的关联：一项挪威基于登记系统的队列研究
10.1007/s10654-020-00600-z
2020-01-16, Article
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Previous studies of fetal death with maternal influenza have been inconsistent. We explored the effect of maternal influenza-like illness (ILI) in pregnancy on the risk of fetal death, distinguishing between diagnoses during regular influenza seasons and the 2009/2010 pandemic and between trimesters of ILI. We used birth records from the Medical Birth Registry of Norway to identify fetal deaths after the first trimester in singleton pregnancies (2006-2013). The Norwegian Directorate of Health provided dates of clinical influenza diagnoses by primary-health-care providers, whereas dates of laboratory-confirmed influenza A (H1N1) diagnoses were provided by the Norwegian Surveillance System for Communicable Diseases. We obtained dates and types of influenza vaccinations from the Norwegian Immunisation Registry. Cox proportional-hazards regression models were fitted to estimate hazard ratios (HRs) of fetal death, with associated 95% confidence intervals (CIs), comparing women with and without an ILI diagnosis in pregnancy. There were 2510 fetal deaths among 417,406 eligible pregnancies. ILI during regular seasons was not associated with increased risk of fetal death: adjusted HR = 0.90 (95% CI 0.64-1.27). In contrast, ILI during the pandemic was associated with substantially increased risk of fetal death, with an adjusted HR of 1.75 (95% CI 1.21-2.54). The risk was highest following first-trimester ILI (adjusted HR = 2.28 [95% CI 1.45-3.59]). ILI during the pandemic-but not during regular seasons-was associated with increased risk of fetal death in the second and third trimester. The estimated effect was strongest with ILI in first trimester.
First Authors:
Nina Gunnes
Correspondence Authors:
Nina Gunnes
All Authors:
Nina Gunnes,Håkon Kristian Gjessing,Inger Johanne Bakken,Sara Ghaderi,Jon Michael Gran,Olav Hungnes,Per Magnus,Sven Ove Samuelsen,Anders Skronda,Camilla Stoltenberg,Lill Trogstad,Allen J Wilcox,Siri Eldevik Håberg
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