A Cross-sectional Surveillance Study of the Frequency and Etiology of Acute Respiratory Illness Among Pregnant Women
A Cross-sectional Surveillance Study of the Frequency and Etiology of Acute Respiratory Illness Among Pregnant Women
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DOI：
10.1093/infdis/jiy167
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发表时间：
2018-08-15
影响因子：
6.4
通讯作者：
Piedra, Pedro A.
中科院分区：
文献类型：
--
作者：
Hause, Anne M.;Avadhanula, Vasanthi;Piedra, Pedro A.
背景资料。除了流感，人们对病毒性急性呼吸道疾病(ARI)对孕妇和胎儿的后果知之甚少。我们的目标是确定由呼吸道病毒引起的ARI的频率和与妊娠相关的临床结果。如果怀孕第二或第三个月的孕妇报告有急性呼吸窘迫综合征的症状或在前两周内健康，则纳入研究。鼻咽分泌物用分子诊断方法检测呼吸道病毒。在登记时和两周后通过基于电话的跟踪调查问卷评估临床结果。155例孕妇，81例急性呼吸窘迫综合征患者和91例健康对照。急性下呼吸道疾病(ALRTI)29例(36%)。人鼻病毒(HRV)、呼吸道合胞病毒(RSV)和流感病毒占ALRTI病毒阳性病例的75%。ALRTI患者经常报告病程较长、过敏史、喘息、呼吸急促或胸痛症状，以及使用处方药。2例ALRTI患者报告胎动减少；1例ALRTI患者住院治疗。在超过三分之一的ARI病例中，参与者的症状与ALRTI一致。在ALRTI患者中通常检测到HRV、RSV或流感病毒的感染。妊娠期病毒性ALRTI似乎很常见，并与显著的发病率有关。
Background. Other than influenza, little is known about the consequences of viral acute respiratory illness (ARI) on pregnant women and fetuses. Our objectives were to determine the frequency of ARI due to respiratory viruses and the associated clinical outcomes during pregnancy.Methods. Pregnant women in their second or third trimester were enrolled if they reported having symptoms of ARI or were healthy within the preceding 2 weeks. Nasopharyngeal secretions were evaluated for respiratory viruses by molecular diagnostic assays. Clinical outcomes were evaluated at enrollment and via a follow-up telephone-based questionnaire 2 weeks later.Results. There were 155 pregnant participants, with 81 ARI cases and 91 healthy controls. Acute lower respiratory tract illness (ALRTI) was identified in 29 cases (36%). Human rhinovirus (HRV), respiratory syncytial virus (RSV), and influenza virus accounted for 75% of virus-positive cases of ALRTI. Cases with ALRTI often reported a longer duration of illness, history of allergies, symptoms of wheezing, shortness of breath, or chest pain, and use of prescription medication. Two cases with ALRTI reported decreased fetal movement; a third case with ALRTI was hospitalized.Conclusions. In over one third of ARI cases, participants had symptoms consistent with ALRTI. Infection with HRV, RSV, or influenza virus was commonly detected in patients with ALRTI. Viral ALRTI during pregnancy appears to be common and is associated with significant morbidity.