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ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 1  |  Page : 20-26

Maternal and perinatal outcomes of influenza in pregnancy after treatment with oseltamivir


1 Department of Obstetrics and Gynaecology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
2 Department of Biostatistics, Christian Medical College Hospital, Vellore, Tamil Nadu, India
3 Department of Virology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
4 Department of Neonatology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
5 Global Health Center, Cincinnati Children's Hospital, Cincinnati, OH, USA

Correspondence Address:
Dr. Kavitha Abraham
Department of Obstetrics and Gynaecology, Christian Medical College and Hospital, Vellore, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jgid.jgid_157_20

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Context: Influenza infection in pregnancy causes 4%–8% case fatality and five times more perinatal mortality. Influenza is a major contributor to mortality in developing countries; however, the morbidity has largely been underestimated. Public health interventions for prevention are also lacking. Aims: This study aimed to determine the seasonality of influenza in pregnant Indian women and to estimate the maternal and perinatal morbidity after treatment with oseltamivir. Settings and Design: This was a prospective observational cohort study, conducted in a tertiary hospital. Subjects and Methods: Pregnant women with ILI (influenza-like illness) were recruited into Cohort 1 (polymerase chain reaction [PCR] positive) and Cohort 2 (PCR negative). Gestational age-matched asymptomatic controls formed Cohort 3. Women in Cohort 1 received oseltamivir for 5 days. The incidence of small-for-gestational age (SGA) and preterm birth were the primary outcomes. Maternal and neonatal morbidity formed the secondary outcomes. Statistical Analysis: Unmatched (Cohort 1 and 2) and matched analysis (Cohort 1 and 3) were done. Student's t-test and Chi-square test were used to compare between variables. Results: Year-round incidence of influenza was recorded. Severe illness was more in Cohort 1 compared to Cohort 2 (36.2% vs. 6.3%; P < 0.001). SGA was comparable in all the cohorts (13%). Preterm birth (7.8% vs. 3.3%; P < 0.08; relative risk-2.75) was considerably high in Cohort 1. Secondary maternal and neonatal outcomes were similar between the groups. Conclusion: Influenza in pregnancy showed year-round incidence and increased maternal and neonatal morbidity despite treatment with oseltamivir. We suggest the need for newer interventions to curtail the illness in pregnancy.


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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008