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. 2017 Sep;107(9):1477-1483.
doi: 10.2105/AJPH.2017.303887. Epub 2017 Jul 20.

1918 Influenza Pandemic: In Utero Exposure in the United States and Long-Term Impact on Hospitalizations

Joseph Kofi Acquah  1 , Roshani Dahal  1 , Frank A Sloan  1
Affiliations

1918 Influenza Pandemic: In Utero Exposure in the United States and Long-Term Impact on Hospitalizations

Joseph Kofi Acquah et al. Am J Public Health. 2017 Sep.

Abstract

Objectives: To explore associations between in utero exposure to the 1918 influenza pandemic and hospitalization rates in old age (≥ 70 years) in the United States.

Methods: We identified individuals exposed (mild and deadly waves) and unexposed in utero to the 1918 influenza pandemic (a natural experiment) by using birth dates from the Asset and Health Dynamics Among the Oldest Old survey. We analyzed differences in hospitalization rates by exposure status with multivariate linear regression.

Results: In utero exposure to the deadly wave of the 1918 influenza pandemic increased the number of hospital visits by 10.0 per 100 persons. For those exposed in utero to the deadliest wave of the influenza pandemic, high rates of functional limitations are shown to drive the higher rates of hospitalizations in old age.

Conclusions: In utero exposure to the influenza pandemic increased functional limitations and hospitalization rates in old age. Public Health Implications. To determine investments in influenza pandemic prevention programs that protect fetal health, policymakers should include long-term reductions in hospitalizations in their cost-benefit evaluations.

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Figures

FIGURE 1—
FIGURE 1—
Differences in Hospitalizations Over Time Between Individuals Exposed and Unexposed In Utero to the Deadly Wave of the 1918 Influenza Pandemic: Asset and Health Dynamics Among the Oldest Old (AHEAD) Survey, United States Note. Both 90% (thin line) and 95% (thick line) confidence intervals are displayed.
See this image and copyright information in PMC

References

    1. Edwards MJ. Review: Hyperthermia and fever during pregnancy. Birth Defects Res A Clin Mol Teratol. 2006;76(7):507–516. - PubMed
    1. Rasmussen SA, Jamieson DJ, Bresee JS. Pandemic influenza and pregnant women. Emerg Infect Dis. 2008;14(1):95–100. - PMC - PubMed
    1. Rasmussen SA, Jamieson DJ, Uyeki TM. Effects of influenza on pregnant women and infants. Am J Obstet Gynecol. 2012;207(3):S3–S8. - PubMed
    1. Almond D. Is the 1918 influenza pandemic over? Long-term effects of in utero influenza exposure in the post-1940 US population. J Polit Econ. 2006;114(4):672–712.
    1. Mazumder B, Almond D, Park K, Crimmins EM, Finch CE. Lingering prenatal effects of the 1918 influenza pandemic on cardiovascular disease. J Dev Orig Health Dis. 2010;1(1):26–34. - PMC - PubMed

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