Time-series Analysis of Seasonal Influenza Activity and Preterm Birth in Atlanta, Georgia from 2010 to 2015 Restricted; Files Only

Wang, Tingyu (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/6395w8404?locale=en



Influenza is one of the most common infectious diseases in the United States. Influenza infection during pregnancy has been hypothesized to increase the risks of adverse birth outcomes. However, current epidemiologic findings remain limited and mixed.


This study aims to assess short-term associations between seasonal influenza activity and the risk of preterm birth in Atlanta from 2010 to 2015.



Singleton live births were obtained from the Georgia Department of Public Health. Daily influenza activity estimates (overall, by type, and by subtype) were obtained from three influenza surveillance networks. Time-series Poisson log-linear models were used to assess associations between daily counts of preterm birth and weekly influenza activity up to a 2-week lag. Models were adjusted for federal holidays, weekdays, seasonality, weekly mean temperature, and long-term time trend.



Significant positive associations were observed between weekly influenza activity and preterm birth. For example, an interquartile range increase in same-week influenza activity measured by the rate of influenza-like illnesses was associated with a 2.4% increase (95% CI: 0.4%, 4.4%) in preterm births. In the analysis of specific influenza types, influenza A was found to elevate the risk of preterm birth.



Our study provides evidence that higher community-level influenza circulation was associated with an increased risk of preterm birth.

Table of Contents

1.    Introduction 1

2.    Methods 3

2.1  Georgia Birth Records 3

2.2  Measures of Influenza Activity 3

2.3  Statistical Analysis 5

3.    Results 8

4.    Discussion 14

Reference 20

Appendix 22

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