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Pregnant Women With Flu Need Antiviral Treatment ASAP

ATLANTA – Pregnant women presenting to the emergency department with severe influenza should be treated as soon as possible with the antiviral drug oseltamivir, even before test results confirm the infection, according to a new study.

An article published online by The Journal of Infectious Diseases notes that expectant mothers are at higher risk for serious illness and complications, including death, from the flu.

Study authors from the national Centers for Disease Control and Prevention recommend that, for expectant mothers hospitalized with flu, speedy initiation of oseltamivir could shorten their time in the hospital, especially in severe cases. Severe influenza was defined by cases involving intensive care unit admission, mechanical ventilation, respiratory failure, pulmonary embolism, sepsis, or leading to death.

"Treating pregnant women who have influenza with antiviral drugs can have substantial benefit in terms of reducing length of stay in the hospital," explained senior author Sandra S. Chaves, MD, MSc, of the CDC. "The earlier you treat, the better chances you have to modify the course of the illness." In an Infectious Diseases Society of America press release, Chaves recommends that antiviral treatment begin even before flu is confirmed.

The new report cites past studies finding that flu antiviral therapy is safe and beneficial for pregnant women.

For the current study, researchers used data from a nationwide flu surveillance network including 14 states, focusing on pregnant women hospitalized with laboratory-confirmed flu over four recent influenza seasons from 2010 to 2014. During the study period, 865 pregnant women were hospitalized with flu, with about 7% of those having severe illness.

Among those severely ill inpatients, researchers found that treatment with the antiviral drug oseltamivir within two days of the start of symptoms was associated with a median length of stay about five days shorter compared to similar patients treated later -- 2.2 days vs. 7.8 days.

While the hospital stay also was reduced in pregnant women hospitalized with less severe illness who were treated early, the difference was not as great, according to the study.

CDC researchers also made another critical point: Pregnant women hospitalized with severe flu illness were half as likely to have been vaccinated as women hospitalized with milder illness – 14% vs. 26%.

Flu vaccination is recommended for everyone 6 months of age and older, including pregnant women during any trimester of their pregnancy. In fact, some research has suggested that immunization during pregnancy protects not only the mother but also her newborn baby during the first six months of life.