Anselem Olivia, Floret Daniel, Tsatsaris Vassilis, Goffinet François, Launay Odile
Maternité Port-Royal, université Paris Descartes, DHU risques et grossesse, PRES Sorbonne Paris Cité, service de gynécologie et obstétrique de Port-Royal, groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France(1).
Presse Med. 2013 Nov;42(11):1453-60. doi: 10.1016/j.lpm.2013.01.064. Epub 2013 May 15.
Pregnant woman have an increased risk of respiratory complications and hospitalization related to influenza. The flu, like any systemic infection, may also be responsible for uterine contractions constituting a threat of miscarriage or premature labor according to gestational age at which it occurs. There is no specific recommendation regarding the management of influenza-like illness in pregnant women, but a nasopharyngeal sample can be performed in the presence of respiratory or general symptoms occurring during an epidemic to search influenza and establish if a specific treatment with oseltamivir (Tamiflu(®)). Surveillance in hospital or intensive care unit may be necessary. Vaccination against influenza provides a satisfactory immunity in pregnant women and reduces the risk of respiratory complications. Transplacental passage of maternal antibody protects newborns who are more likely to have severe influenza infection and because the vaccine cannot be administered before the age of 6 months. The available data show good tolerance influenza vaccination performed during pregnancy. Since 2012, vaccination against seasonal influenza is recommended for pregnant women, whatever the stage of pregnancy at the time of the vaccination campaign.
孕妇发生与流感相关的呼吸道并发症及住院的风险增加。流感与任何全身性感染一样,根据其发生时的孕周,也可能导致子宫收缩,构成流产或早产的威胁。对于孕妇流感样疾病的管理没有具体建议,但在疫情期间出现呼吸道或全身症状时,可采集鼻咽样本以检测流感,并确定是否使用奥司他韦(达菲®)进行特异性治疗。可能需要在医院或重症监护病房进行监测。流感疫苗接种可为孕妇提供良好的免疫力,并降低呼吸道并发症的风险。母体抗体经胎盘传递可保护更易发生严重流感感染的新生儿,因为在6个月龄之前不能接种疫苗。现有数据表明孕期进行流感疫苗接种耐受性良好。自2012年以来,无论在疫苗接种活动时处于孕期哪个阶段,均建议孕妇接种季节性流感疫苗。