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Article(id=1324077471791984695, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508103, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1755014400000, receivedDateStr=2025-08-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614269445, onlineDateStr=2026-11-02, pubDate=1775750400000, pubDateStr=2026-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614269445, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614269445, creator=13701087609, updateTime=1793614269445, updator=13701087609, issue=Issue{id=1324077443828560770, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='7', pageStart='1153', pageEnd='1344', issueExtLink='null', onlineDate='null', pubDate='1775750400000', pubDateStr='2026-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614262778, creator='13701087609', updateTime=1793614352085, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324077818509918661, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324077818509918662, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1246, endPage=1250, ext={EN=ArticleExt(id=1324077473645867066, articleId=1324077471791984695, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Influencing factors of influenza infection in hospitalized pregnant and postpartum women during influenza seasons in Suzhou from 2018 to 2023, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate influencing factors of influenza virus infection among hospitalized pregnant and postpartum women during influenza season in Suzhou City.

Methods

Based on the established active surveillance system for influenza-associated acute respiratory or febrile illness (ARFI) hospitalizations among the maternal population in Suzhou, we used rates/percentages to describe population distribution characteristics. Logistic regression analyses were performed to identify factors associated with laboratory-confirmed influenza infection in hospitalized pregnant and postpartum women during influenza season.

Results

During 2018—2023 influenza seasons, 1 774 pregnant and postpartum women hospitalized with ARFI were included, with 479 cases (27.0%) testing positive and 1 295 negative by reverse transcription polymerase chain reaction (RT-PCR). Multivariable analysis confirmed that elevated risks persisted in first (aOR=2.49, 95% CI: 1.52-4.11) and third trimesters (aOR=1.83, 95% CI: 1.27-2.68). Influenza like illness (ILI) exposure increased risk by 86.0% (aOR=1.86, 95% CI: 1.36-2.55). Asthma was associated with an 83.0% lower risk (aOR=0.17, 95% CI: 0.03-0.56). Having ILI symptoms within the past 1 year (aOR=0.70, 95% CI: 0.51-0.94) and having children (aOR=0.77, 95% CI: 0.62-0.96) were also associated with a reduced risk of hospitalization with influenza infection.

Conclusion

Pregnant women in first and third trimesters should strengthen self-protection measures against seasonal influenza. Attention to health-related behaviors significantly reduces infection risks.

, authors=Wan-ting HONG1, 2, Jing-hui SUN1, 2, Rui WANG1, 3, Yuan-yuan ZHANG1, Li-ling CHEN1, 2, 3, authorsList=Wan-ting HONG, Jing-hui SUN, Rui WANG, Yuan-yuan ZHANG, Li-ling CHEN, authorCompany=null, correspAuthors=Li-ling CHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077473973022779, articleId=1324077471791984695, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=苏州市2018—2023年流感季住院孕产妇流感感染的影响因素研究, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

探讨苏州市流感季住院孕产妇流感病毒感染的影响因素。

方法

基于苏州市前期建立的全人群孕产妇流感相关急性呼吸道或发热性疾病（acute respiratory or febrile illness，ARFI）住院情况的主动监测，采用率/构成比表示流感感染住院孕产妇的人群分布，采用logistic回归分析流感季住院孕产妇实验室确诊流感感染的影响因素。

结果

在2018—2023年流感流行期内因ARFI住院的孕产妇共1 774人，其中479例（27.0%）实验室逆转录聚合酶链式反应（reverse transcription polymerase chain reaction，RT-PCR）检测阳性，RT-PCR检测阴性的有1 295人。通过logistic回归分析苏州市孕产妇流感季流感病毒感染住院的影响因素，多因素分析结果显示：孕早期（aOR=2.49，95%CI：1.52~4.11）与孕晚期（aOR=1.83，95% CI：1.27~2.68）的风险仍显著高于孕中期；有流感样病例（influenza like illness，ILI）接触史使风险增加86.0%（aOR=1.86，95% CI：1.36~2.55）；哮喘患者风险降低83.0%（aOR=0.17，95% CI：0.03~0.56）；1年内出现过ILI症状（aOR=0.70，95% CI：0.51~0.94）、已有孩子（aOR=0.77，95% CI：0.62~0.96）与流感住院风险降低相关。

结论

处于孕早期和孕晚期的孕妇应加强自身的防护以防止季节性流感感染，重视自身健康相关行为可显著降低感染流感的风险。

, authors=洪婉婷1, 2, 孙静慧1, 2, 王睿1, 3, 张媛媛1, 陈立凌1, 2, 3, authorsList=洪婉婷, 孙静慧, 王睿, 张媛媛, 陈立凌, authorCompany=null, correspAuthors=陈立凌, authorNote=

洪婉婷（2000—），女，硕士在读，研究方向：流行病学

, correspAuthorsNote=
陈立凌，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=ZLwKHG5qGce0d+kVaaDY4A==, magXml=fGhktFcqpdPb8dqJW+RCBw==, pdfUrl=null, pdf=E42rCOPMTvBcZzyYkxjYnQ==, pdfFileSize=831658, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=MlPcJuP43Yvsg4zewE1osA==, mapNumber=null, fund=null)}, authors=[Author(id=1324077474623139908, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077471791984695, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1324077474727997511, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077471791984695, authorId=1324077474623139908, language=EN, stringName=Wan-ting HONG, firstName=Wan-ting, middleName=null, lastName=HONG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=Suzhou Center for Disease Control and Prevention, Suzhou, Jiangsu 215131, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1324077474828660808, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077471791984695, authorId=1324077474623139908, language=CN, stringName=洪婉婷, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=1, 2, address=1.苏州市疾病预防控制中心，江苏　苏州　215131
2.南京医科大学公共卫生学院，江苏　南京　211100, bio={"content":"

洪婉婷（2000—），女，硕士在读，研究方向：流行病学

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洪婉婷（2000—），女，硕士在读，研究方向：流行病学

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2.南京医科大学公共卫生学院，江苏　南京　211100
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The mechanisms and therapeutic implications of PI3K signaling in airway inflammation and remodeling in asthma[J]. Biologics: Targets & Therapy, 2025, 19: 73-86., articleTitle=The mechanisms and therapeutic implications of PI3K signaling in airway inflammation and remodeling in asthma, refAbstract=null), Reference(id=1324077480142844028, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077471791984695, doi=null, pmid=null, pmcid=null, year=2020, volume=173, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[12], rfOrder=13, authorNames=Feddema JJ, Claassen E, journalName=Respiratory Medicine, refType=null, unstructuredReference=Feddema JJ, Claassen E. Prevalence of viral respiratory infections amongst asthmatics: Results of a meta-regression analysis[J]. 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Characteristics of pregnant and postpartum women hospitalized with influenza-associated ARFI in Suzhou, October 2018—September 2023 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
特征2018年10月—2019年09月（n=229）2019年10月—2020年09月（n=96）2020年10月—2021年09月（n=1）2021年10月—2022年09月（n=76）2022年10月—2023年09月（n=77）总计（n=479）
年龄（岁）
20~2427（11.8）7（7.3）0（0.0）9（11.8）11（14.3）54（11.3）
25~2995（41.5）45（46.9）0（0.0）27（35.5）28（36.4）195（40.7）
30~3479（34.5）37（38.5）1（100.0）28（36.8）23（29.9）168（35.1）
35~3924（10.5）6（6.3）0（0.0）10（13.2）15（19.5）55（11.5）
40~444（1.7）1（1.0）0（0.0）2（2.6）0（0.0）7（1.5）
职业
保育员及保姆0（0.0）1（1.0）0（0.0）0（0.0）0（0.0）1（0.2）
餐饮食品业2（0.9）1（1.0）0（0.0）1（1.3）1（1.3）5（1.0）
干部职员94（41.0）18（18.8）0（0.0）13（17.1）16（20.8）141（29.4）
工人12（5.2）15（15.6）0（0.0）15（19.7）14（18.2）56（11.7）
家务及待业69（30.1）24（25.0）1（100.0）17（22.4）23（29.9）134（28.0）
教师9（3.9）5（5.2）0（0.0）5（6.6）5（6.5）24（5.0）
商业服务19（8.3）14（14.6）0（0.0）16（21.1）12（15.6）61（12.7）
医务人员10（4.4）5（5.2）0（0.0）3（3.9）0（0.0）18（3.8）
自由职业1（0.4）4（4.2）0（0.0）2（2.6）1（1.3）8（1.7）
其他13（5.7）9（9.4）0（0.0）4（5.3）5（6.5）31（6.5）
学历
小学或以下1（0.4）1（1.0）0（0.0）0（0.0）0（0.0）2（0.4）
初中/中专44（19.2）18（18.8）1（100.0）20（26.3）27（35.1）110（23.0）
高中/职高27（11.8）4（4.2）0（0.0）7（9.2）5（6.5）43（9.0）
大专69（30.1）33（34.4）0（0.0）24（31.6）19（24.7）145（30.3）
本科79（34.5）37（38.5）0（0.0）24（31.6）23（29.9）163（34.0）
研究生及以上9（3.9）3（3.1）0（0.0）1（1.3）3（3.9）16（3.3）
家庭总年收入（万元）
<58（3.5）8（8.3）0（0.0）4（5.3）3（3.9）23（4.8）
5~945（19.7）13（13.5）0（0.0）11（14.5）22（28.6）91（19.0）
10~1458（25.3）33（34.4）1（100.0）35（46.1）19（24.7）146（30.5）
15~1967（29.3）18（18.8）0（0.0）13（17.1）17（22.1）115（24.0）
20~2431（13.5）12（12.5）0（0.0）4（5.3）6（7.8）53（11.1）
≥2520（8.7）12（12.5）0（0.0）9（11.8）10（13.0）51（10.6）
妊娠分期
孕早期19（8.3）15（15.6）0（0.0）7（9.2）9（11.7）50（10.4）
孕中期9（3.9）9（9.4）0（0.0）9（11.8）12（15.6）39（8.1）
孕晚期193（84.3）70（72.9）1（100.0）60（78.9）56（72.7）380（79.3）
产妇8（3.5）2（2.1）0（0.0）0（0.0）0（0.0）10（2.1）
), ArticleFig(id=1324077478167326824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077471791984695, language=CN, label=表1, caption=

2018年10月—2023年09月苏州市流感ARFI住院孕产妇人群特征分布情况[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
特征2018年10月—2019年09月（n=229）2019年10月—2020年09月（n=96）2020年10月—2021年09月（n=1）2021年10月—2022年09月（n=76）2022年10月—2023年09月（n=77）总计（n=479）
年龄（岁）
20~2427（11.8）7（7.3）0（0.0）9（11.8）11（14.3）54（11.3）
25~2995（41.5）45（46.9）0（0.0）27（35.5）28（36.4）195（40.7）
30~3479（34.5）37（38.5）1（100.0）28（36.8）23（29.9）168（35.1）
35~3924（10.5）6（6.3）0（0.0）10（13.2）15（19.5）55（11.5）
40~444（1.7）1（1.0）0（0.0）2（2.6）0（0.0）7（1.5）
职业
保育员及保姆0（0.0）1（1.0）0（0.0）0（0.0）0（0.0）1（0.2）
餐饮食品业2（0.9）1（1.0）0（0.0）1（1.3）1（1.3）5（1.0）
干部职员94（41.0）18（18.8）0（0.0）13（17.1）16（20.8）141（29.4）
工人12（5.2）15（15.6）0（0.0）15（19.7）14（18.2）56（11.7）
家务及待业69（30.1）24（25.0）1（100.0）17（22.4）23（29.9）134（28.0）
教师9（3.9）5（5.2）0（0.0）5（6.6）5（6.5）24（5.0）
商业服务19（8.3）14（14.6）0（0.0）16（21.1）12（15.6）61（12.7）
医务人员10（4.4）5（5.2）0（0.0）3（3.9）0（0.0）18（3.8）
自由职业1（0.4）4（4.2）0（0.0）2（2.6）1（1.3）8（1.7）
其他13（5.7）9（9.4）0（0.0）4（5.3）5（6.5）31（6.5）
学历
小学或以下1（0.4）1（1.0）0（0.0）0（0.0）0（0.0）2（0.4）
初中/中专44（19.2）18（18.8）1（100.0）20（26.3）27（35.1）110（23.0）
高中/职高27（11.8）4（4.2）0（0.0）7（9.2）5（6.5）43（9.0）
大专69（30.1）33（34.4）0（0.0）24（31.6）19（24.7）145（30.3）
本科79（34.5）37（38.5）0（0.0）24（31.6）23（29.9）163（34.0）
研究生及以上9（3.9）3（3.1）0（0.0）1（1.3）3（3.9）16（3.3）
家庭总年收入（万元）
<58（3.5）8（8.3）0（0.0）4（5.3）3（3.9）23（4.8）
5~945（19.7）13（13.5）0（0.0）11（14.5）22（28.6）91（19.0）
10~1458（25.3）33（34.4）1（100.0）35（46.1）19（24.7）146（30.5）
15~1967（29.3）18（18.8）0（0.0）13（17.1）17（22.1）115（24.0）
20~2431（13.5）12（12.5）0（0.0）4（5.3）6（7.8）53（11.1）
≥2520（8.7）12（12.5）0（0.0）9（11.8）10（13.0）51（10.6）
妊娠分期
孕早期19（8.3）15（15.6）0（0.0）7（9.2）9（11.7）50（10.4）
孕中期9（3.9）9（9.4）0（0.0）9（11.8）12（15.6）39（8.1）
孕晚期193（84.3）70（72.9）1（100.0）60（78.9）56（72.7）380（79.3）
产妇8（3.5）2（2.1）0（0.0）0（0.0）0（0.0）10（2.1）
), ArticleFig(id=1324077478263795817, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077471791984695, language=EN, label=Table 2, caption=

Univariate analysis of influencing factors for influenza infection in pregnant and postpartum women hospitalized with influenza-associated ARFI during influenza seasons, 2018—2023 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量流感ARFI非流感ARFIχ2值P值
高龄（年龄≥35）0.7850.376
是62（12.9）189（14.6）
否417（87.1）1 106（85.4）
除本人外家中常住人口>2人0.4110.521
是380（79.3）1 045（80.7）
否99（20.7）250（19.3）
孕前BMI分级2.1300.546
偏瘦62（12.9）162（12.5）
正常309（64.5）805（62.2）
超重85（17.7）245（18.9）
肥胖23（4.8）83（6.4）
孕期增重状态0.5480.760
增重不足140（29.2）390（30.1）
正常范围180（37.6）499（38.5）
增重超重159（33.2）406（31.4）
妊娠分期31.356<0.001
孕早期50（10.4）99（7.6）
孕中期39（8.1）180（13.9）
孕晚期380（79.3）923（71.3）
产妇10（2.1）93（7.2）
学历9.2690.010
高中及以下155（32.4）515（39.8）
大专145（30.3）323（24.9）
本科及以上179（37.4）457（35.3）
家庭总年收入（万元）1.3920.499
<10114（23.8）336（25.9）
10~20261（54.5）666（51.4）
>20104（21.7）293（22.6）
苏州医保0.7990.371
是307（64.1）800（61.8）
否172（35.9）495（38.2）
既往史
有1项及以上基础疾病a2.6450.104
是34（7.1）124（9.6）
否445（92.9）1 171（90.4）
哮喘8.2080.004
是2（0.4）33（2.5）
否477（99.6）1 262（97.5）
发病前两周接触过ILI患者14.874<0.001
是80（16.7）130（10.0）
否399（83.3）1 165（90.0）
1年内出现过ILI症状2.9250.087
是68（14.2）228（17.6）
否411（85.8）1 067（82.4）
听说过流感疫苗2.4930.114
是210（43.8）514（39.7）
否269（56.2）781（60.3）
妊娠史
初次妊娠0.0180.894
是177（37.0）483（37.3）
否302（63.0）812（62.7）
已有孩子8.9900.003
是234（48.9）736（56.8）
否245（51.1）559（43.2）
妊娠期糖尿病0.0020.967
是64（13.4）174（13.4）
否415（86.6）1 121（86.6）
妊娠期高血压1.4750.225
是14（2.9）54（4.2）
否465（97.1）1 241（95.8）
孕前或孕期营养品5.2020.023
是281（58.7）681（52.6）
否198（41.3）614（47.4）
孕期服药1.2540.263
是88（18.4）269（20.8）
否391（81.6）1 026（79.2）
), ArticleFig(id=1324077478381236330, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077471791984695, language=CN, label=表2, caption=

2018—2023年流感季ARFI住院孕产妇流感感染影响因素的单因素分析[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量流感ARFI非流感ARFIχ2值P值
高龄（年龄≥35）0.7850.376
是62（12.9）189（14.6）
否417（87.1）1 106（85.4）
除本人外家中常住人口>2人0.4110.521
是380（79.3）1 045（80.7）
否99（20.7）250（19.3）
孕前BMI分级2.1300.546
偏瘦62（12.9）162（12.5）
正常309（64.5）805（62.2）
超重85（17.7）245（18.9）
肥胖23（4.8）83（6.4）
孕期增重状态0.5480.760
增重不足140（29.2）390（30.1）
正常范围180（37.6）499（38.5）
增重超重159（33.2）406（31.4）
妊娠分期31.356<0.001
孕早期50（10.4）99（7.6）
孕中期39（8.1）180（13.9）
孕晚期380（79.3）923（71.3）
产妇10（2.1）93（7.2）
学历9.2690.010
高中及以下155（32.4）515（39.8）
大专145（30.3）323（24.9）
本科及以上179（37.4）457（35.3）
家庭总年收入（万元）1.3920.499
<10114（23.8）336（25.9）
10~20261（54.5）666（51.4）
>20104（21.7）293（22.6）
苏州医保0.7990.371
是307（64.1）800（61.8）
否172（35.9）495（38.2）
既往史
有1项及以上基础疾病a2.6450.104
是34（7.1）124（9.6）
否445（92.9）1 171（90.4）
哮喘8.2080.004
是2（0.4）33（2.5）
否477（99.6）1 262（97.5）
发病前两周接触过ILI患者14.874<0.001
是80（16.7）130（10.0）
否399（83.3）1 165（90.0）
1年内出现过ILI症状2.9250.087
是68（14.2）228（17.6）
否411（85.8）1 067（82.4）
听说过流感疫苗2.4930.114
是210（43.8）514（39.7）
否269（56.2）781（60.3）
妊娠史
初次妊娠0.0180.894
是177（37.0）483（37.3）
否302（63.0）812（62.7）
已有孩子8.9900.003
是234（48.9）736（56.8）
否245（51.1）559（43.2）
妊娠期糖尿病0.0020.967
是64（13.4）174（13.4）
否415（86.6）1 121（86.6）
妊娠期高血压1.4750.225
是14（2.9）54（4.2）
否465（97.1）1 241（95.8）
孕前或孕期营养品5.2020.023
是281（58.7）681（52.6）
否198（41.3）614（47.4）
孕期服药1.2540.263
是88（18.4）269（20.8）
否391（81.6）1 026（79.2）
), ArticleFig(id=1324077478477705323, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077471791984695, language=EN, label=Table 3, caption=

Multivariable analysis of influencing factors for influenza infection in pregnant and postpartum women hospitalized with influenza-associated ARFI during influenza seasons, 2018—2023

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βwaldχ2值OR（95%CI）P值
妊娠分期
孕早期0.91212.9252.49（1.52-4.11）<0.001
孕中期1.00
孕晚期0.60410.0621.83（1.27-2.68）0.002
产妇-0.6733.0600.51（0.23-1.04）0.078
学历
高中及以下-0.2232.8600.80（0.62-1.04）0.100
大专0.1130.6741.12（0.85-1.46）0.400
本科及以上1.00
哮喘
是-1.7725.6330.17（0.03-0.56）0.015
否1.00
发病前两周接触过ILI患者
是0.62114.9761.86（1.36-2.55）<0.001
否1.00
1年内出现过ILI症状
是-0.3571.0950.70（0.51-1.94）0.020
否1.00
已有孩子
是-0.2615.4910.77（0.62-0.96）0.021
否1.00
孕前或孕期营养品
是0.2153.7021.24（1.00-1.55）0.055
否1.00
), ArticleFig(id=1324077478553202796, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077471791984695, language=CN, label=表3, caption=

2018—2023年流感季ARFI住院孕产妇流感感染影响因素的多因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βwaldχ2值OR（95%CI）P值
妊娠分期
孕早期0.91212.9252.49（1.52-4.11）<0.001
孕中期1.00
孕晚期0.60410.0621.83（1.27-2.68）0.002
产妇-0.6733.0600.51（0.23-1.04）0.078
学历
高中及以下-0.2232.8600.80（0.62-1.04）0.100
大专0.1130.6741.12（0.85-1.46）0.400
本科及以上1.00
哮喘
是-1.7725.6330.17（0.03-0.56）0.015
否1.00
发病前两周接触过ILI患者
是0.62114.9761.86（1.36-2.55）<0.001
否1.00
1年内出现过ILI症状
是-0.3571.0950.70（0.51-1.94）0.020
否1.00
已有孩子
是-0.2615.4910.77（0.62-0.96）0.021
否1.00
孕前或孕期营养品
是0.2153.7021.24（1.00-1.55）0.055
否1.00
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苏州市2018—2023年流感季住院孕产妇流感感染的影响因素研究
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洪婉婷 1, 2 , 孙静慧 1, 2 , 王睿 1, 3 , 张媛媛 1 , 陈立凌 1, 2, 3
现代预防医学 | 儿少卫生与妇幼保健 2026,53(7): 1246-1250
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (7) : 1246 -1250
苏州市2018—2023年流感季住院孕产妇流感感染的影响因素研究
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2.南京医科大学公共卫生学院，江苏　南京　211100
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洪婉婷1, 2, 孙静慧1, 2, 王睿1, 3, 张媛媛1, 陈立凌1, 2, 3
作者信息
  • 1.苏州市疾病预防控制中心，江苏　苏州　215131
  • 2.南京医科大学公共卫生学院，江苏　南京　211100
  • 3.徐州医科大学公共卫生学院，江苏　徐州　221004
通讯作者:
陈立凌，E-mail：
作者简介:

洪婉婷（2000—），女，硕士在读，研究方向：流行病学

Influencing factors of influenza infection in hospitalized pregnant and postpartum women during influenza seasons in Suzhou from 2018 to 2023
Wan-ting HONG1, 2, Jing-hui SUN1, 2, Rui WANG1, 3, Yuan-yuan ZHANG1, Li-ling CHEN1, 2, 3
Affiliations
  • Suzhou Center for Disease Control and Prevention, Suzhou, Jiangsu 215131, China
出版时间: 2026-04-10 doi: 10.20043/j.cnki.MPM.202508103
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摘要
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目的

探讨苏州市流感季住院孕产妇流感病毒感染的影响因素。

方法

基于苏州市前期建立的全人群孕产妇流感相关急性呼吸道或发热性疾病（acute respiratory or febrile illness，ARFI）住院情况的主动监测，采用率/构成比表示流感感染住院孕产妇的人群分布，采用logistic回归分析流感季住院孕产妇实验室确诊流感感染的影响因素。

结果

在2018—2023年流感流行期内因ARFI住院的孕产妇共1 774人，其中479例（27.0%）实验室逆转录聚合酶链式反应（reverse transcription polymerase chain reaction，RT-PCR）检测阳性，RT-PCR检测阴性的有1 295人。通过logistic回归分析苏州市孕产妇流感季流感病毒感染住院的影响因素，多因素分析结果显示：孕早期（aOR=2.49，95%CI：1.52~4.11）与孕晚期（aOR=1.83，95% CI：1.27~2.68）的风险仍显著高于孕中期；有流感样病例（influenza like illness，ILI）接触史使风险增加86.0%（aOR=1.86，95% CI：1.36~2.55）；哮喘患者风险降低83.0%（aOR=0.17，95% CI：0.03~0.56）；1年内出现过ILI症状（aOR=0.70，95% CI：0.51~0.94）、已有孩子（aOR=0.77，95% CI：0.62~0.96）与流感住院风险降低相关。

结论

处于孕早期和孕晚期的孕妇应加强自身的防护以防止季节性流感感染，重视自身健康相关行为可显著降低感染流感的风险。

流感  /  孕产妇  /  影响因素
Objective

To investigate influencing factors of influenza virus infection among hospitalized pregnant and postpartum women during influenza season in Suzhou City.

Methods

Based on the established active surveillance system for influenza-associated acute respiratory or febrile illness (ARFI) hospitalizations among the maternal population in Suzhou, we used rates/percentages to describe population distribution characteristics. Logistic regression analyses were performed to identify factors associated with laboratory-confirmed influenza infection in hospitalized pregnant and postpartum women during influenza season.

Results

During 2018—2023 influenza seasons, 1 774 pregnant and postpartum women hospitalized with ARFI were included, with 479 cases (27.0%) testing positive and 1 295 negative by reverse transcription polymerase chain reaction (RT-PCR). Multivariable analysis confirmed that elevated risks persisted in first (aOR=2.49, 95% CI: 1.52-4.11) and third trimesters (aOR=1.83, 95% CI: 1.27-2.68). Influenza like illness (ILI) exposure increased risk by 86.0% (aOR=1.86, 95% CI: 1.36-2.55). Asthma was associated with an 83.0% lower risk (aOR=0.17, 95% CI: 0.03-0.56). Having ILI symptoms within the past 1 year (aOR=0.70, 95% CI: 0.51-0.94) and having children (aOR=0.77, 95% CI: 0.62-0.96) were also associated with a reduced risk of hospitalization with influenza infection.

Conclusion

Pregnant women in first and third trimesters should strengthen self-protection measures against seasonal influenza. Attention to health-related behaviors significantly reduces infection risks.

Influenza  /  Pregnant and postpartum women  /  Influencing factors
洪婉婷, 孙静慧, 王睿, 张媛媛, 陈立凌. 苏州市2018—2023年流感季住院孕产妇流感感染的影响因素研究. 现代预防医学, 2026 , 53 (7) : 1246 -1250 . DOI: 10.20043/j.cnki.MPM.202508103
Wan-ting HONG, Jing-hui SUN, Rui WANG, Yuan-yuan ZHANG, Li-ling CHEN. Influencing factors of influenza infection in hospitalized pregnant and postpartum women during influenza seasons in Suzhou from 2018 to 2023[J]. Modern Preventive Medicine, 2026 , 53 (7) : 1246 -1250 . DOI: 10.20043/j.cnki.MPM.202508103
正文
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流行性感冒（简称“流感”）是流感病毒引起的对人类健康危害严重的急性呼吸道传染病。流感病毒的抗原漂移和抗原转换特性导致其持续进化，每年季节性流感流行在世界范围内可致300~500万的严重感染病例，并造成29~65万例呼吸道疾病相关死亡[1]，每年导致超500万成人住院治疗[2]。各地研究资料表明，孕妇因流感病毒感染而患病的风险增加[3]，在感染流感的育龄妇女中，怀孕妇女最有可能患上严重的流感相关疾病[4]。由于孕产妇流感感染的高风险性，明确其感染的危险因素对于制定精准的防控策略至关重要。然而，国内常规监测系统难以精准识别孕产妇流感感染情况[5]，为了估计孕妇和产后2周内女性患流感住院的风险，我们突破国内常规流感监测体系的局限，创新性地构建了依靠信息化手段识别病例的监测系统，于2018年10月1日—2023年9月30日，在苏州地区开展了一项针对医疗机构孕产妇流感住院病例的主动监测。本研究通过探讨苏州市流感季住院孕产妇流感病毒感染的影响因素，为制定针对性干预措施提供科学依据。
1　对象与方法
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1.1　对象
本项目于2018年10月—2023年9月在中国江苏省苏州（人口约1 300万）整个大市范围内（覆盖10个县市区）开展，利用信息化手段实现了基于全人群的孕产妇流感相关急性呼吸道或发热性疾病（acute respiratory or febrile illness，ARFI）住院情况的主动监测，监测人群为苏州市所有因发热或急性呼吸道感染而收住入院的孕产妇人群。利用ICD-10代码和体温记录对每日上传的住院病例信息中的ARFI病例进行筛查，筛查范围为全市每日的女性住院病例，年龄为≥20岁且<50岁，并且入院诊断符合以下任一大类。纳入标准还包括入院时及入院48 h内体温≥37.3℃的记录。较为宽泛的疾病诊断编码范围和体温阈值被用来捕获尽可能多的与流感感染相关的病例。对所有根据监测病例定义捕获的住院患者由收治医院的床位医生或床位护士通过问询、体检和实验室检测明确其孕产状态，确定为孕妇或产妇（产后2周内）的病例，经知情同意后纳入监测病例。监测病例来源于苏州大市范围内所有可能收治急性呼吸道感染孕产妇住院病例的医疗机构。本研究已通过江苏省疾病预防控制中心和苏州市疾病预防控制中心伦理委员会批准。[审查批准号为JSJK2018-B020-02、SZJK2019-001、SZJK2020-002、SZJKCF-001、202014（Y）01]。
1.2　标本采集和实验室检测
对所有符合监测病例定义的病例，在签署知情同意书后纳入本项目。纳入后由患者收治医院的医护人员收集孕产妇的个人基本信息，并且在24 h内采集患者的鼻咽标本，所有标本填写送样单并于24 h内送至苏州市疾控中心的国家流感网络实验室，期间标本保存温度为低温冷藏，运送条件符合生物标本生物安全要求。苏州市流感监测网络实验室收到呼吸道标本后，在24 h内进行逆转录聚合酶链式反应（reverse transcription polymerase chain reaction，RT-PCR）检测，阳性标本进行流感亚型检测，检测结果通过辖区疾控中心反馈至孕产妇收治医院。流感病毒PCR检测试剂与国家流感网络实验室使用一致。
1.3　质量控制
本研究参与人员覆盖疾病预防控制中心、医疗机构、妇幼保健所等不同单位成员，所有调查人员将在项目开始前接受统一的规范化培训，主要针对研究过程中的具体操作流程和注意事项，考核合格方可参与，所有调查与采样均使用统一设计的调查表和采样单。资料整理分析阶段要求实行双人双遍录入并比对的方式，确保信息的准确。
1.4　统计学方法
收集到的问卷使用EpiData 3.0软件建立数据库进行录入，整理和逻辑校对并做一致性检验。使用R 4.3.0软件进行统计学描述和分析。采用率/构成比表示流感ARFI住院孕产妇人群特征分布情况；采用χ2检验进行苏州市孕产妇季节性流感病毒感染住院的影响因素分析，将单因素分析结果中P<0.10的变量作为自变量进入二分类logistic逐步回归方程进行多因素分析，检验水准α=0.05。
2　结果
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2.1　流感季流感ARFI住院孕产妇人群分布
在2018年10月—2023年9月流感流行期间，接受鼻咽拭子采样并送至实验室检测的1 774例患者中，479例ARFI住院孕产妇经实验室RT-PCR检测阳性（流感ARFI），流感阳性率为27%，PCR检测阴性（非流感ARFI）有1 295例。
2018年10月—2023年9月苏州市流感季ARFI住院孕产妇中经实验室确诊流感阳性的妇女年龄分布在20~44岁，75.8%孕产妇年龄分布在25~34岁（n=363），高龄孕产妇（年龄大于等于35岁者）占13.0%（n=62），年龄中位数为29岁。流感阳性ARFI住院孕产妇的职业分布以干部职员占比最高，占29.4%（n=141），家务及待业其次，占28.0%（n=134）。64.3%的孕产妇学历是大专（n=145，30.3%）或本科（n=163，34.0%）。家庭总年收入以10~14万为主，占30.5%（n=146）。479名罹患流感的妇女中，10人入院时为产后2周内，其余469人入院时为怀孕状态，其中380名（79.3%）孕妇处于孕晚期，39名孕妇（8.1%）处于孕中期，50名孕妇（10.4%）处于孕早期，中位孕周为36周。见表1。
2.2　流感季ARFI住院孕产妇流感感染的影响因素
通过χ2检验分析苏州市流感季的孕产妇流感病毒感染住院的影响因素。χ2分析结果显示：在妊娠分期组、学历组、是否患哮喘组、发病前是否两周接触过流感样病例（influenza like illness，ILI）组、是否已有孩子组以及孕前或孕期是否服用营养品组间有差异（均有P<0.05），其余组间均无差异。见表2。
选取单因素分析结果中P<0.10的变量进入多因素logistic回归模型进一步筛选出独立危险因素，结果显示：孕早期（aOR=2.49，95%CI：1.52~4.11，P<0.001）与孕晚期（aOR=1.83，95% CI：1.27~2.68，P=0.002）的风险仍显著高于孕中期。有ILI接触史使风险增加86.0%（aOR=1.86，95% CI：1.36~2.55，P<0.001）。哮喘患者风险降低83.0%（aOR=0.17，95% CI：0.03~0.56，P=0.015）。1年内出现过ILI症状（aOR=0.70，95% CI：0.51~0.94，P=0.020）以及已有孩子（aOR=0.77，95% CI：0.62~0.96，P=0.021）与流感住院风险降低相关。见表3。
3　讨论
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本研究系统评估了苏州市孕产妇季节性流感住院风险的独立影响因素，结果显示，孕晚期的流感住院风险显著高于孕中期。其他研究也发现怀孕后半期的孕妇出现住院[6]的风险增加。新加坡的一项研究中，妊娠中期妇女的住院率增加1.2倍，妊娠晚期妇女的住院率增加2.3倍[7]。Liu等[8]在一项综述中观察到类似的发现，来自不同地理区域的7项研究结果显示，9.1%的甲型流感（pH1N1）感染病例发生在妊娠早期，29.8%发生在妊娠中期，47.0%发生在妊娠晚期。
另外，我们的研究还发现孕早期流感住院风险高于孕中期，这可能与主动医疗行为相关。我们还发现接触ILI患者是另一关键风险因素，提示家庭或社区内流感传播对孕产妇健康的直接威胁。有文献表明，流感病毒传播风险与不同人群的接触频率存在显著关联[9]，因此孕期健康教育应强调避免接触呼吸道感染患者，并鼓励家庭成员接种流感疫苗以形成群体免疫屏障。此外，1年内出现过ILI症状是使孕产妇流感住院风险降低的因素，这可能与免疫记忆的交叉保护效应有关。一项对妊娠期女性的队列研究发现，接种流感疫苗可将ILI发病率降低33.5%[10]，类似地，自然感染后的免疫记忆可能通过交叉保护效应降低后续感染住院风险。
本研究发现，患有哮喘的孕产妇因流感感染住院的风险显著降低。我们推测，这并非哮喘本身具有生理保护作用，更可能源于患者本身的防护意识。由于病毒性呼吸道感染可诱发哮喘的急性发作[11]，且哮喘患者孕期的生理变化使其对健康状况更为警觉。因此，该群体可能在整个流感季都保持着远超普通孕产妇的防护依从性。在一项关于哮喘患者病毒性感染患病率的meta分析中显示，流感病毒（7.0%~15.0%）的检出率远小于鼻病毒（51.0%~71.0%）[12]。2021年8月发表在《欧洲呼吸学杂志》上的一项荟萃分析揭示了相似的结论，哮喘患者感染SARS-CoV-2的风险低于非哮喘患者[13]。这种高度的自我防护很可能有效地切断了病毒的传播途径，从而大幅降低了暴露和感染的风险。这一现象提示，针对高危人群的健康教育，应着重强化其对于疾病严重后果的认知，以转化为积极的自我保护行动。
已有孩子的孕产妇流感住院的保护作用可能与经产妇健康行为与风险意识的提高有关。经产妇因育儿经验，更重视孕期健康管理，出现症状更早寻求医疗干预（如抗病毒治疗），避免病情进展到需住院的程度。经产妇在流感季节为了保护年幼的子女，其个人防护意识（如洗手、家庭环境消毒）和推动家庭成员（包括配偶和老人）接种疫苗的意愿通常更强。这种以保护孩子为原动力的、更高标准的家庭防护体系，在无形中也为自己建立了一道坚实的屏障，显著减少了病毒在家庭内部的传播。
本文还存在一些局限性。苏州市作为中国东部经济发达地区代表性城市之一，高等教育普及率达78.4%，导致研究结果在外推到资源欠发达地区受到限制。研究聚焦住院孕产妇流感易感因素时，面临孕激素动态变化带来的复杂混杂效应，使得妊娠期女性与健康育龄女性缺乏可比性的基础。本研究对于上述保护因素（包括经产妇身份、哮喘等）背后确切机制的阐释，仍属于基于流行病学关联的合理推论，未能直接收集和比较不同组别之间具体的防护行为频率指标。
基金
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  • 中美新发和再发传染病合作项目(6U01IP001106-01-01)
  • 苏州市2022年度第二十七批科技发展计划（社会发展科技创新）项目(2022SS14)
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参考文献 引证文献
排序方式：
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Iuliano AD, Roguski KM, Chang HH, et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study[J]. Lancet, 2018, 391(10127): 1285-1300.
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Guzman-Holst A, Petrozzi V, Velez C, et al. Knowledge, attitudes, and practices concerning maternal immunization among pregnant/postpartum women and health care professionals in Peru[J]. Infectious Diseases and Therapy, 2023, 12(4): 1151-1173.
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Pang JJ, Wang S, Cui HY, et al. Analysis on surveillance results of inpatients with severe acute respiratory infection cases in a sentinel hospital of Beijing from 2016 to 2020[J]. Journal of Preventive Medicine Information, 2022, 38(7): 972-976. (In Chinese)
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Lim ML. 2009/H1N1 infection in pregnancy association with adverse perinatal outcomes[J]. Evidence-based Nursing, 2012, 15(1): 11-12.
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Liu SL, Wang J, Yang XH, et al. Pandemic influenza A (H1N1) 2009 virus in pregnancy[J]. Reviews in Medical Virology, 2013, 23(1): 3-14.
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Grijalva CG, Nguyen HQ, Zhu YW, et al. Estimated effectiveness of influenza vaccines in preventing secondary infections in households[J]. JAMA Netw Open, 2024, 7(11): e2446814.
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梁雪枫, 彭娟霞, 孙迪, 等. 甘肃省妊娠期接种流感疫苗预防孕妇流感样疾病保护效果的真实世界数据回顾性队列研究[J]. 中国疫苗和免疫, 2024, 30(4): 432-435.
Liang XF, Peng JX, Sun D, et al. Effectiveness of influenza vaccination during pregnancy against influenza-like illness among pregnant women: a retrospective cohort study using real-world data in Gansu province[J]. Chinese Journal of Vaccines and Immunization, 2024, 30(4): 432-435. (In Chinese)
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Song BG, Hu JH, Chen SP, et al. The mechanisms and therapeutic implications of PI3K signaling in airway inflammation and remodeling in asthma[J]. Biologics: Targets & Therapy, 2025, 19: 73-86.
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Feddema JJ, Claassen E. Prevalence of viral respiratory infections amongst asthmatics: Results of a meta-regression analysis[J]. Respiratory Medicine, 2020, 173: 106020.
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Sunjaya AP, Allida SM, Di Tanna GL, et al. Asthma and COVID-19 risk: a systematic review and meta-analysis[J]. European Respiratory Journal, 2022, 59(3): 2101209.
2026年第53卷第7期
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doi: 10.20043/j.cnki.MPM.202508103
  • 接收时间：2025-08-13
  • 首发时间：2026-11-02
  • 出版时间：2026-04-10
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  • 收稿日期：2025-08-13
基金
中美新发和再发传染病合作项目(6U01IP001106-01-01)
苏州市2022年度第二十七批科技发展计划（社会发展科技创新）项目(2022SS14)
作者信息
    1.苏州市疾病预防控制中心，江苏　苏州　215131
    2.南京医科大学公共卫生学院，江苏　南京　211100
    3.徐州医科大学公共卫生学院，江苏　徐州　221004

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陈立凌，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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