Reviewed by Jen Cihlar, DO, Vanderbilt University Medical Center
Systematic review looking at outcomes of pregnant people diagnosed with avian influenza A found a 90% mortality rate of pregnant mothers and 86% fetal mortality rate, albeit through a very limited number of studies. This highlights the importance of proactively including this vulnerable patient population in future vaccine research and implementation efforts.
The authors conducted a systemic review looking at 30 cases of pregnant people diagnosed with confirmed avian influenza. Studies were excluded if they did not report on primary outcome, those in which pregnant women were not differentiated from other study participants, and those reporting duplicate data, which ultimately came down to 7 case reports and 1 retrospective cohort study, for a total of 30 patients. Overall, outcomes were poor with maternal death in 90.0% (n = 27) of cases and in 86.6% (26/30) cases fetuses died with the mothers. Five infants survived 4 had premature births. The authors recognized that there is limited information specifically regarding outcomes of this patient population, and while certainly there could be less severe cases that are more likely to be detected, their review overall highlights a vulnerable patient population that historically has worse adverse outcomes than the general population for influenza among other viruses.
They wanted to raise awareness that this group is very often excluded from initial vaccine research and implementation efforts and there needs to be a dogma shift from presumptive exclusion of pregnant people to a pregnancy-focused research agenda developed and implemented by ethically informed oversight from institutional review boards, regulators, and policy makers to avoid preventable deaths.
Reference:
Purcell R, Giles ML, Crawford NW, et al. Systematic Review of Avian Influenza Virus Infection and Outcomes during Pregnancy. Emerging Infectious Diseases. 2025;31(1):50-56. doi:10.3201/eid3101.241343.