Travel Characteristics and Pretravel Health Care Among Pregnant or Breastfeeding U.S. Women Preparing for International Travel

Details

• Alternative Title:
  Obstet Gynecol
• Personal Author:
  Hagmann, Stefan H. F. ; Rao, Sowmya R. ; LaRocque, Regina C. ; Erskine, Stefanie ; Jentes, Emily S. ; Walker, Allison T. ; Barnett, Elizabeth D. ; Chen, Lin H. ; Hamer, Davidson H. ; Ryan, Edward T.
• Corporate Authors:
  for the Global TravEpiNet Consortium and the Boston Area Travel Medicine Network
• Description:
  OBJECTIVE
  
  To study characteristics and preventive interventions of adult pregnant and breastfeeding travelers seeking pretravel health care in the United States.
  
  METHODS
  
  This cross-sectional study analyzed data (2009–2014) of pregnant and breastfeeding travelers seen at U.S. travel clinics participating in Global TravEpiNet. Nonpregnant, nonbreastfeeding adult female travelers of childbearing age were used for comparison. We evaluated the prescription of malaria chemoprophylaxis and antibiotics for this population as well as the administration of three travel-related vaccines: hepatitis A, typhoid, and yellow fever. We also evaluated use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis and influenza vaccines, because these are widely recommended in pregnancy.
  
  RESULTS
  
  Of 21,138 female travelers of childbearing age in Global TravEpiNet, 170 (0.8%) were pregnant and 139 (0.7%) were breastfeeding. Many traveled to destinations endemic for mosquito-borne illnesses, including malaria (pregnant: 95%; breastfeeding: 94%), dengue (pregnant: 87%; breastfeeding: 81%), or yellow fever (pregnant: 35%; breastfeeding: 50%). Compared with nonpregnant, nonbreastfeeding adult female travelers, eligible pregnant travelers were less likely to be vaccinated against hepatitis A (28% compared with 51%, P<.001) and typhoid (35% compared with 74%, P<.001). More than 20% of eligible pregnant travelers did not receive influenza vaccination. Yellow fever vaccine was occasionally provided to pregnant and breastfeeding travelers traveling to countries entirely endemic for yellow fever (6 [20%] of 30 pregnant travelers and 18 [46%] of 39 breastfeeding travelers). Half of pregnant travelers and two thirds of breastfeeding travelers preparing to travel to malaria-holoendemic countries received a prescription for malaria prophylaxis.
  
  CONCLUSION
  
  Most pregnant and breastfeeding travelers seen for pretravel health consultations traveled to destinations with high risk for vector-borne or other travel-related diseases. Destination-specific preventive interventions were frequently underused.
  
  
• Subjects:
  Adult Breast Feeding Chemoprevention Cross-Sectional Studies Dengue Female Health Services Misuse Humans Malaria Pregnancy Pregnant Women Travel Travel-Related Illness Vaccination Yellow Fever

  More +
• Source:
  Obstet Gynecol. 130(6):1357-1365.
• Pubmed ID:
  29112671
• Pubmed Central ID:
  PMC5909816
• Document Type:
  Journal Article
• Funding:
  U01 CK000175/CK/NCEZID CDC HHS/United States ; U01 CK000490/CK/NCEZID CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  130
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3990609e4bab62aae689d3742949266ebf03f7f3e63c6911c93f7486d4634699
• Download URL:
  https://stacks.cdc.gov/view/cdc/53617/cdc_53617_DS1.pdf
• File Type:
  [PDF - 423.85 KB ]