Outcomes of a Negative Rapid Influenza Diagnostic Test in Pregnant Women

Ilina Datkhaeva; Phinnara Has; Kelly Fitzgerald; Brenna L. Hughes

doi:10.1055/s-0038-1666975

American Journal of Perinatology, Table of Contents

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

Authors

Ilina Datkhaeva

¹Department of Obstetrics and Gynecology, University of California, Los Angeles, California

²Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, Rhode Island
Phinnara Has

²Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, Rhode Island
Kelly Fitzgerald

³Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
Brenna L. Hughes

⁴Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina

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.

Keywords

influenza - pregnancy - diagnostic test - rapid - treatment

Full Text

References

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