H1N1 infection in pregnant women

January 01, 0001

H1N1 infection in pregnant women

The pandemic 2009 influenza A(H1N1) virus raised a great deal of concern when it first emerged, but subsequent reports found it to be less lethal than first thought. However, it concerns persist regarding its lethality in pregnant patient. These US researchers sought to characterize the severity of 2009 influenza A(H1N1) illness and any link with early antiviral treatment among pregnant women. They used data reported to the USCenters for Disease Control and Prevention (CDC) with symptom onset from April through December 2009 in pregnant women.

The researchers state: "We received reports on 788 pregnant women in the United States with 2009 influenza A(H1N1) with symptom onset from April through August 2009. Among those, 30 died (5% of all reported 2009 influenza A{H1N1}influenza deaths in this period). Among 509 hospitalized women, 115 (22.6%) were admitted to an ICU. Pregnant women with treatment more than 4 days after symptom onset were more likely to be admitted to an ICU (56.9% vs 9.4%, RR 6.0) than those treated within 2 days after symptom onset. Only 1 death occurred in a patient who received treatment within 2 days of symptom onset. Updating these data with the CDC's continued surveillance of ICU admissions and deaths among pregnant women with symptom onset through December 31, 2009, identified an additional 165 women for a total of 280 women who were admitted to ICUs, 56 of whom died. Among the deaths, 4 occurred in the first trimester (7.1%), 15 in the second (26.8%), and 36 in the third (64.3%)."

The researchers concluded: "Pregnant women had a disproportionately high risk of mortality due to 2009 influenza A(H1N1). Among pregnant women with 2009 influenza A(H1N1) influenza reported to the CDC, early antiviral treatment appeared to be associated with fewer admissions to an ICU and fewer deaths."

This study reaffirms the importance of early detection and antiviral treatment for pandemic H1N1 influenza A in pregnant patients.

For the full abstract, click here.

JAMA 303(15):1517-1525, 21 April 2010 © 2010 the American Medical Association
Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States. Alicia M. Siston, Sonja A. Rasmussen, Margaret A. Honein, et al.

Category: R. Respiratory, W. Pregnancy, Family Planning. Keywords: influenza, H1N1, pregnancy, hospitalization, mortality, epidemiological study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 11 May 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

COVID-19 Resources

WONCA webinars, journal links and more

WONCA position statements

WONCA statements on a variety of issues

PEARLS

577 Individual behavioural counselling helps people to quit smoking 575 Antioxidant vitamin and mineral supplements may be beneficial in age-related macular degeneration 574 Oral antifungals effective for toenail onychomycosis 570 Decision aids beneficial for people facing health treatment or screening decisions 569 Computer-generated reminders on paper benefit quality of care