title: Possible association of influenza A with fetal loss: investigation of a cluster of spontaneous abortions and stillbirths.
abstract: It has been suspected that influenza infection is associated with fetal or perinatal mortality, but little recent evidence supports this hypothesis. A small cluster of early and late fetal deaths in early 1986 prompted an epidemiological investigation. Women whose pregnancies were affected (cases) were compared with women whose pregnancies had a normal outcome (controls). Case pregnancies were distinguished by a significant excess of recent flu-like illness (p = 0.006), and were significantly more likely than controls to have serological evidence of influenza A infection (p = 0.00067), predominantly the influenza A H3N2, Christchurch/4/85-like strain. The cluster was recognised because most cases were patients of one health centre. Larger epidemiological studies will be needed to confirm an association between influenza A and fetal death, but this cluster suggests that influenza A may have an adverse influence on fetal survival.
authors.affiliation: PHLS Communicable Disease Surveillance Centre, London.
authors.forename: R
authors.initials: R
authors.lastname: Stanwell-Smith
authors.forename: A M
authors.initials: AM
authors.lastname: Parker
authors.forename: P
authors.initials: P
authors.lastname: Chakraverty
authors.forename: N
authors.initials: N
authors.lastname: Soltanpoor
authors.forename: C N
authors.initials: CN
authors.lastname: Simpson
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology*; D000328:Adult; D016000:Cluster Analysis; D004739:England / Q000453:epidemiology; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D006801:Humans; D009980:Influenza A virus; D007251:Influenza, Human / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D014852:Wales / Q000453:epidemiology