Impact of pregnancy on observed sex disparities among adults hospitalized with laboratory‐confirmed influenza, FluSurv‐NET, 2010‐2012

Media type: E-Article
Title: Impact of pregnancy on observed sex disparities among adults hospitalized with laboratory‐confirmed influenza, FluSurv‐NET, 2010‐2012
Contributor: Kline, Kelly; Hadler, James L.; Yousey‐Hindes, Kimberly; Niccolai, Linda; Kirley, Pam D.; Miller, Lisa; Anderson, Evan J.; Monroe, Maya L.; Bohm, Susan R.; Lynfield, Ruth; Bargsten, Marisa; Zansky, Shelley M.; Lung, Krista; Thomas, Ann R.; Brady, Diane; Schaffner, William; Reed, Gregg; Garg, Shikha
imprint: Wiley, 2017
Published in: Influenza and Other Respiratory Viruses
Language: English
DOI: 10.1111/irv.12465
ISSN: 1750-2640; 1750-2659
Keywords: Infectious Diseases ; Public Health, Environmental and Occupational Health ; Pulmonary and Respiratory Medicine ; Epidemiology
Origination:
Footnote:
Description: <jats:sec><jats:title>Introduction</jats:title><jats:p>Previous FluSurv‐<jats:styled-content style="fixed-case">NET</jats:styled-content> studies found that adult females had a higher incidence of influenza‐associated hospitalizations than males. To identify groups of women at higher risk than men, we analyzed data from 14 FluSurv‐<jats:styled-content style="fixed-case">NET</jats:styled-content> sites that conducted population‐based surveillance for laboratory‐confirmed influenza‐associated hospitalizations among residents of 78 <jats:styled-content style="fixed-case">US</jats:styled-content> counties.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We analyzed 6292 laboratory‐confirmed, geocodable (96%) adult cases collected by FluSurv‐<jats:styled-content style="fixed-case">NET</jats:styled-content> during the 2010‐12 influenza seasons. We used 2010 <jats:styled-content style="fixed-case">US</jats:styled-content> Census and 2008‐2012 American Community Survey data to calculate overall age‐adjusted and age group‐specific female:male incidence rate ratios (<jats:styled-content style="fixed-case">IRR</jats:styled-content>) by race/ethnicity and census tract‐level poverty. We used national 2010 pregnancy rates to estimate denominators for pregnant women aged 18‐49. We calculated male:female <jats:styled-content style="fixed-case">IRR</jats:styled-content>s excluding them and <jats:styled-content style="fixed-case">IRR</jats:styled-content>s for pregnant:non‐pregnant women.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Overall, 55% of laboratory‐confirmed influenza cases were female. Female:male <jats:styled-content style="fixed-case">IRR</jats:styled-content>s were highest for females aged 18‐49 of high neighborhood poverty (<jats:styled-content style="fixed-case">IRR</jats:styled-content> 1.50, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 1.30‐1.74) and of Hispanic ethnicity (<jats:styled-content style="fixed-case">IRR</jats:styled-content> 1.70, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 1.34‐2.17). These differences disappeared after excluding pregnant women. Overall, 26% of 1083 hospitalized females aged 18‐49 were pregnant. Pregnant adult females were more likely to have influenza‐associated hospitalizations than their non‐pregnant counterparts (relative risk [<jats:styled-content style="fixed-case">RR</jats:styled-content>] 5.86, 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 5.12‐6.71), but vaccination levels were similar (25.5% vs 27.8%).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Overall rates of influenza‐associated hospitalization were not significantly different for men and women after excluding pregnant women. Among women aged 18‐49, pregnancy increased the risk of influenza‐associated hospitalization sixfold but did not increase the likelihood of vaccination. Improving vaccination rates in pregnant women should be an influenza vaccination priority.</jats:p></jats:sec>
Access State: Open Access

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