苏州市2015-2018年孕产妇季节性流感病毒感染的影响因素研究

Study of influencing factors of seasonal influenza virus infection in pregnant women in Suzhou,2015-2018

目的探讨2015-2018年苏州市孕产妇季节性流感病毒感染的影响因素。方法基于2015-2018年在苏州市开展的孕产妇人群流感随访队列资料,描述队列人群的基本情况和流感病毒感染后的临床特征,采用非条件logistic回归分析孕产妇实验室确诊流感病毒感染的影响因素。结果共招募19006名孕产妇,其中实验室确诊流感病例479名,A(H3N2)(42.8%)为主要的病毒亚型。在有流感流行期暴露风险的人群中,非条件单因素logistic回归分析结果显示,孕产妇或者其丈夫户籍在苏州市、职业为保育员及保姆、除本人外家中常住人口>2人、在苏州市有医疗保险、在苏州有生育险、纳入时为孕晚期、近一个月有过咳嗽、第一次怀孕、已有孩子、怀孕前后户外时间比以前多、怀孕前后戴口罩频率比以前多、怀孕前后聚会频率有改变均与孕产妇流感病毒感染有关,其中第一次怀孕、怀孕前后户外时间比以前多、怀孕前后戴口罩频率比以前多、怀孕前后聚会频率有改变为保护因素;非条件多因素logistic回归分析结果显示,家中常住人口>2人(aOR=1.24,95%CI:1.01~1.52)、孕晚期(aOR=1.56,95%CI:1.26~1.91)是孕产妇感染流感病毒的危险因素。结论家中常住人口数较多及孕晚期的孕产妇更要注意预防季节性流感。

Objective To explore the influencing factors of seasonal influenza among pregnant woman in Suzhou from 2015 to 2018.Methods Based on the data of the influenza follow-up cohort of pregnant women in Suzhou from 2015 to 2018,the basic and clinical characteristics of the cohort were described,and the influencing factors of laboratory-confirmed influenza cases in pregnant women were analyzed by unconditional logistic regression.Results A total of 19006 pregnant women were recruited,in whom 479 cases of influenza were laboratory confirmed.Influenza A(H3N2)(42.8%)was the main sub-type.In pregnant women with exposure risk in influenza season,unconditional univariate logistic analysis showed that pregnant women or their husbands had registered permanent residence in Suzhou,pregnant women worked as childminder or nanny,had more than 2 permanent residents in the family except themselves,had medical insurance in Suzhou,had fertility insurance in Suzhou,were in the third trimester at the time of enrollment,had cough in the past month,were pregnant for the first time,had children,before and after pregnancy,spent more time outdoors than before,wore masks more often than before and had changed the frequency of gathering were all related to influenza virus infection in pregnant women.Among them,the first pregnancy,increasing the time of outdoor activity,increasing the frequency of wearing masks,and changing the frequency of gathering were important protective factors.Unconditional multivariate logistic regression analysis showed that the number of permanent residents at home was>2(aOR=1.24,95%CI:1.01-1.52)and being in the third trimester,(aOR=1.56,95%CI:1.26-1.91)were the risk factors for maternal infection with influenza virus.Conclusion Pregnant women with a large number of permanent residents and late pregnancy should pay attention to preventing seasonal influenza.