A Cross-Sectional Surveillance Study of Acute Respiratory Illness (ARI) in Pregnant Women

BACKGROUND: Among pregnant women, pneumonia is the third-leading cause of death and the most common non-obstetric infection resulting in death. Pregnant women who become infected with influenza have hospitalization rates comparable to non-pregnant women with high-risk medical conditions. Other than influenza, little is known about the consequences of viral-related ARI on the pregnant woman and the fetus. Our objective was to determine the respiratory viruses causing ARI and their clinical outcomes during pregnancy. METHODS: Pregnant women in their second and third trimester were enrolled prospectively at a Houston clinic between October 1, 2015 and April 30, 2016 during their regular prenatal visits. Pregnant women were enrolled if they reported having symptoms of ARI or were healthy within the preceding two weeks. Nasal-pharyngeal secretions were evaluated for respiratory viruses by real time-PCR. Clinical outcomes and complications of illness were obtained at enrollment and two weeks after the initial visit. RESULTS: A total of 155 pregnant women were enrolled. The average age at enrollment was 30.7 years among women with ARI and 29.7 among healthy controls. Average gestational age at enrollment was 26.0 weeks among women with ARI and 26.3 among healthy controls. Among the 91 healthy controls, 10 (11%) tested positive for a respiratory virus, with rhinovirus (n = 6) being the most common of the viruses detected. On the other hand, of the 81 cases of ARI, 51 (63%) tested positive for a virus. The most frequently detected viruses were rhinovirus (n = 22), coronavirus (n = 14), and respiratory syncytial virus (n = 8). Twelve patients reported fever during the course of their ARI. Seventeen ARI patients reported at least one symptom of lower respiratory tract illness (LRTI). Of those patients with LRTI, two reported decreased fetal heart rate and one was hospitalized for her illness. CONCLUSION: Respiratory viruses were frequently detected in pregnant women with ARI. One-third of pregnant women with viral ARI had evidence of LRTI. Hospitalization and non-reassuring fetal heart tones were among the complications reported by pregnant women with LRTI. Viral ARI during pregnancy appears common and is associated with significant morbidity. DISCLOSURES: All authors: No reported disclosures.