Am J Perinatol 2019; 36(01): 090-096
DOI: 10.1055/s-0038-1666975
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Outcomes of a Negative Rapid Influenza Diagnostic Test in Pregnant Women

Ilina Datkhaeva
1   Department of Obstetrics and Gynecology, University of California, Los Angeles, California
2   Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, Rhode Island
,
Phinnara Has
2   Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, Rhode Island
,
Kelly Fitzgerald
3   Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
,
Brenna L. Hughes
4   Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

21 October 2017

03 June 2018

Publication Date:
09 July 2018 (online)

Abstract

Objective The objective of this study was to evaluate the negative predictive value (NPV) of a rapid influenza diagnostic test (RIDT) compared with polymerase chain reaction (PCR) in pregnant women.

Study Design Retrospective cohort study of pregnant women with a negative RIDT followed by confirmatory PCR for influenza A, H1N1, and B during the influenza seasons from 2012 to 2015.

Results The NPV of the RIDT was 85.4% (211 of 247), 93.5% (231 of 247), and 97.9% (242 of 247) for influenza A, H1N1, and B, respectively. Antiviral treatment was administered to 47.2% (17 of 36) of women with a false-negative RIDT for influenza A compared with 9.0% (19 of 211) of women with a true-negative RIDT (p< 0.001). Patients were more likely to receive antiviral treatment if they were feverish (adjusted odds ratio [aOR]: 6.05, 95% confidence interval [CI]: 1.83–20.03), had cough (aOR: 6.43, 95% CI: 1.06–39.26), dyspnea (aOR: 6.41, 95% CI: 1.63–25.29), or had a subsequently positive PCR (aOR: 9.41, 95% CI: 3.13–28.31).

Conclusion Up to 14.5% of women with a negative RIDT in pregnancy had positive influenza A by PCR of whom more than half did not receive antiviral treatment.

Note

Oral presentation at the Infectious Disease Society of Obstetrics and Gynecology Annual Meeting in Annapolis, Maryland, August 11–13, 2016.


 
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