title: Antiviral medication use in a cohort of pregnant women during the 2009-2010 influenza pandemic.
abstract: Preventing influenza-like illness (ILI) during pregnancy with antiviral medication use (AVMU) can mitigate serious health risks to mother and foetus. We report on AVMU in pregnant women in Ontario, Canada, and describe characteristics of AVMU during the 2009-2010 H1N1 pandemic. Rates and risk estimates of AVMU were compared across multiple categories and stratified across ILI infection status. Increased AVMU was observed in women with influenza infections, active smokers, those vaccinated against influenza, and those with pre-existing co-morbidities. Decreased AVMU was observed in women with multiple gestations, and those in neighbourhoods of high immigrant concentrations. Our stratified analysis indicated that the observed patterns differed by ILI infection status. We demonstrated that once infected, women across multiple groups were equally likely to use antiviral medications. In this report we also propose possible clinical explanations for the observed differences in AVMU, which will be useful in planning prevention initiatives for future pandemics.
authors.affiliation: a Better Outcomes Registry & Network (BORN) Ontario , Ottawa , ON , Canada.|d Clinical Epidemiology Program, Ottawa Hospital Research Institute , Ottawa , ON , Canada.|f Children's Hospital of Eastern Ontario (CHEO), Research Institute , Ottawa , ON , Canada.
authors.forename: A S
authors.initials: AS
authors.lastname: Yasseen
authors.affiliation: f Children's Hospital of Eastern Ontario (CHEO), Research Institute , Ottawa , ON , Canada.
authors.forename: D B
authors.initials: DB
authors.lastname: Fell
authors.affiliation: f Children's Hospital of Eastern Ontario (CHEO), Research Institute , Ottawa , ON , Canada.
authors.forename: A E
authors.initials: AE
authors.lastname: Sprague
authors.affiliation: b Obstetric & Maternal Newborn Investigations (OMNI) , Ottawa , ON , Canada.
authors.forename: R
authors.initials: R
authors.lastname: Xie
authors.affiliation: e Department of Obstetrics and Gynecology , Queen's University , Kingston , ON , Canada.
authors.forename: G
authors.initials: G
authors.lastname: Smith
authors.affiliation: a Better Outcomes Registry & Network (BORN) Ontario , Ottawa , ON , Canada.|b Obstetric & Maternal Newborn Investigations (OMNI) , Ottawa , ON , Canada.|c Department of Obstetrics and Gynecology , University of Ottawa , Ottawa , ON , Canada.|d Clinical Epidemiology Program, Ottawa Hospital Research Institute , Ottawa , ON , Canada.
authors.forename: M C
authors.initials: MC
authors.lastname: Walker
authors.affiliation: b Obstetric & Maternal Newborn Investigations (OMNI) , Ottawa , ON , Canada.|c Department of Obstetrics and Gynecology , University of Ottawa , Ottawa , ON , Canada.|d Clinical Epidemiology Program, Ottawa Hospital Research Institute , Ottawa , ON , Canada.
authors.forename: S W
authors.initials: SW
authors.lastname: Wen
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines / Q000008:administration & dosage; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D009864:Ontario / Q000453:epidemiology; D058873:Pandemics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000517:prevention & control; D011272:Pregnancy, Multiple; D012907:Smoking
chemical_list: D000998:Antiviral Agents; D007252:Influenza Vaccines
keywords: Antiviral; H1N1; Influenza; antiviral medication; pregnancy; pregnant women