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Choi WS, Choi MJ, Noh JY, Song JY, Kim WJ, Park DW, Lee J, Seo YB, Baek JH, Choi S, Cheong HJ. Clinical and economic analysis of the 2009 H1N1 influenza pandemic among pregnant Korean women. Korean J Intern Med 2019; 34:1136-1144. [PMID: 29232939 PMCID: PMC6718764 DOI: 10.3904/kjim.2017.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/29/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Unlike Western countries, the 2009 pandemic influenza infection among pregnant women was reported as mild in a previous interim study in South Korea. However, several mortalities were reported thereafter, suggesting that nationwide data were lacking. METHODS This case-control study covers the entire 2009 pandemic inf luenza period, from May 2009 to February 2010. The clinical and economic data of pregnant (case) and age-matched non-pregnant (control) women with influenza A (H1N1) pdm09 virus (H1N1pdm09) infection were retrospectively collected from nine hospitals in South Korea. RESULTS A total of 130 pregnant women with H1N1pdm09 infection were identified. The mean age of the pregnant women was 31.1 years (range, 19 to 41) and mean gestational age was 18.4 weeks (range, 3 to 40). Both case and control groups were similar in terms of age (p = 0.43) and comorbidities (p = 0.18). The overall rate of complications was comparable between the two groups (p = 0.648). However, mortality was reported only among the cases, so mean economic per capita burden is estimated to be higher for pregnant women compared to the control (4,821,992 Korean won [KRW] vs. 351,233 KRW, p = 0.31). Obstetric complications were observed in 12 cases, including preterm labor (n = 7), low birth-weight (n = 3), miscarriage (n = 1), stillbirth (n = 1), and cleft lip (n = 1). CONCLUSION Although statistically insignificant, the detrimental impact of influenza A H1N1pdm09 on pregnancy can be serious in some complicated cases in South Korea. Thus, the strong recommendation of influenza vaccination should be maintained for pregnant women as a high priority.
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Affiliation(s)
- Won Suk Choi
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Min Joo Choi
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Yoon Noh
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dae Won Park
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jacob Lee
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Yu Bin Seo
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Ji Hyeon Baek
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Sooran Choi
- Department of Obstetrics and Gynecology, Inha University College of Medicine, Incheon, Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Correspondence to Hee Jin Cheong, M.D. Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea Tel: +82-2-2626-3050 Fax: +82-2-2626-1105 E-mail:
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He J, Liu ZW, Lu YP, Li TY, Liang XJ, Arck PC, Huang SM, Hocher B, Chen YP. A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight. Kidney Blood Press Res 2017; 42:232-243. [PMID: 28514782 DOI: 10.1159/000477221] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/27/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Impaired pregnancy outcomes, such as low birth weight are associated with increased disease risk in later life, however little is known about the impact of common infectious diseases during pregnancy on birth weight. The study had two aims: a) to investigate risk factors of influenza virus infection during pregnancy, and b) to analyze the impact of influenza virus infection on pregnancy outcome, especially birth weight. METHODS Prospective and retrospective observational studies found in PubMed, MEDLINE, Embase, Google Scholar, and WangFang database were included in this meta analysis. Data of included studies was extracted and analyzed by the RevMan software. RESULTS Pregnant women with anemia (P=0.004, RR=1.46, 95% CI: 1.13-1.88), obesity (P<0.00001, RR=1.35, 95% CI: 1.25-1.46) and asthma (P<0.00001, RR=1.99, 95% CI: 1.67-2.37) had higher rates of influenza virus infection. Regarding birth outcomes, influenza A virus infection did not affect the likelihood for cesarean section. Mothers with influenza had a higher rate of stillbirth (P=0.04, RR=2.36, 95% CI: 1.05-5.31), and their offspring had low 5-minute APGR Scores (P=0.009, RR=1.39, 95% CI: 1.08-1.79). Furthermore, the rate for birth weight < 2500g (P=0.04, RR=1.71, 95% CI: 1.03-2.84) was increased. CONCLUSION Results of this study showed that anemia, asthma and obesity during pregnancy are risk factors influenza A virus infection during pregnancy. Moreover, gestational influenza A infection impairs pregnancy outcomes and increases the risk for low birth weight, a known risk factor for later life disease susceptibility.
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Affiliation(s)
- Jing He
- Department of Infectious Diseases, the first Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhi-Wei Liu
- Department of Infectious Diseases, the first Affiliated Hospital of Jinan University, Guangzhou, China.,Huidong County People's Hospital, Huizhou, China
| | - Yong-Ping Lu
- Department of Infectious Diseases, the first Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Nutritional Science, University of Potsdam, Nuthetal, Potsdam, Germany
| | - Tao-Yuan Li
- Department of Infectious Diseases, the first Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xu-Jing Liang
- Department of Infectious Diseases, the first Affiliated Hospital of Jinan University, Guangzhou, China
| | - Petra C Arck
- Laboratory for Experimental Feto-maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Si-Min Huang
- Department of Infectious Diseases, the first Affiliated Hospital of Jinan University, Guangzhou, China
| | - Berthold Hocher
- Department of Infectious Diseases, the first Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Nutritional Science, University of Potsdam, Nuthetal, Potsdam, Germany.,Institut für Laboratoriumsmedizin Berlin (IFLb), Berlin, Germany.,Department of Embryology, Medical Faculty, Jinan University, Guangzhou, China
| | - You-Peng Chen
- Department of Infectious Diseases, the first Affiliated Hospital of Jinan University, Guangzhou, China
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Choi WS, Choi JH, Kwon KT, Seo K, Kim MA, Lee SO, Hong YJ, Lee JS, Song JY, Bang JH, Choi HJ, Choi YH, Lee DG, Cheong HJ. Revised adult immunization guideline recommended by the korean society of infectious diseases, 2014. Infect Chemother 2015; 47:68-79. [PMID: 25844267 PMCID: PMC4384453 DOI: 10.3947/ic.2015.47.1.68] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Indexed: 11/24/2022] Open
Affiliation(s)
- Won Suk Choi
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jung-Hyun Choi
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ki Tae Kwon
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Kyung Seo
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
| | - Min A Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Oh Lee
- Department of Internal Medicine, Ulsan University College of Medicine, Ulsan, Korea
| | - Young Jin Hong
- Department of Pediatrics, Inha University College of Medicine, Incheon, Korea
| | - Jin-Soo Lee
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Joon Young Song
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Hwan Bang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hee-Jung Choi
- Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea
| | - Young-Hwa Choi
- Department of Internal Medicine, Ajou University College of Medicine, Suwon, Korea
| | - Dong Gun Lee
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Kim JE, Kim UJ, Kim HK, Cho SK, An JH, Kang SJ, Park KH, Jung SI, Jang HC. Predictors of viral pneumonia in patients with community-acquired pneumonia. PLoS One 2014; 9:e114710. [PMID: 25531901 PMCID: PMC4273967 DOI: 10.1371/journal.pone.0114710] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 11/12/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Viruses are increasingly recognized as major causes of community-acquired pneumonia (CAP). Few studies have investigated the clinical predictors of viral pneumonia, and the results have been inconsistent. In this study, the clinical predictors of viral pneumonia were investigated in terms of their utility as indicators for viral pneumonia in patients with CAP. METHODS Adult patients (≥ 18 years old) with CAP, tested by polymerase chain reaction (PCR) for respiratory virus, at two teaching hospitals between October 2010 and May 2013, were identified retrospectively. Demographic and clinical data were collected by reviewing the hospital electronic medical records. RESULTS During the study period, 456 patients with CAP were identified who met the definition, and 327 (72%) patients were tested using the respiratory virus PCR detection test. Viral pneumonia (n = 60) was associated with rhinorrhea, a higher lymphocyte fraction in the white blood cells, lower serum creatinine and ground-glass opacity (GGO) in radiology results, compared to non-viral pneumonia (n = 250) (p < 0.05, each). In a multivariate analysis, rhinorrhea (Odd ratio (OR) 3.52; 95% Confidence interval (CI), 1.58-7.87) and GGO (OR 4.68; 95% CI, 2.48-8.89) were revealed as independent risk factors for viral pneumonia in patients with CAP. The sensitivity, specificity, positive- and negative-predictive values (PPV and NPV) of rhinorrhea were 22, 91, 36 and 83%: the sensitivity, specificity, PPV and NPV of GGO were and 43, 84, 40 and 86%, respectively. CONCLUSION Symptom of rhinorrhea and GGO predicted viral pneumonia in patients with CAP. The high specificity of rhinorrhea and GGO suggested that these could be useful indicators for empirical antiviral therapy.
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Affiliation(s)
- Ji Eun Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Republic of Korea
| | - Uh Jin Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Republic of Korea
| | - Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Republic of Korea
| | - Soo Kyung Cho
- Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Republic of Korea
| | - Joon Hwan An
- Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Republic of Korea
| | - Seung-Ji Kang
- Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Republic of Korea
| | - Kyung-Hwa Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Republic of Korea
| | - Sook-In Jung
- Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Republic of Korea
| | - Hee-Chang Jang
- Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Republic of Korea
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Wong VWY, Tarrant M. Influenza-like illness among Hong Kong Chinese pregnant women. J Matern Fetal Neonatal Med 2014; 28:116-9. [DOI: 10.3109/14767058.2014.900042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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