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Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States
Journal article   Open access   Peer reviewed

Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States

Alicia M. Siston, Sonja A. Rasmussen, Margaret A. Honein, Alicia M. Fry, Katherine Seib, William M. Callaghan, Janice Louie, Timothy J. Doyle, Molly Crockett, Ruth Lynfield, …
JAMA : the journal of the American Medical Association, Vol.303(15), pp.1517-1525
04/21/2010
DOI: 10.1001/jama.2010.479
PMCID: PMC5823273
PMID: 20407061
url
https://doi.org/10.1001/jama.2010.479View
Published (Version of record) Open Access

Abstract

Context Early data on pandemic 2009 influenza A(H1N1) suggest pregnant women are at increased risk of hospitalization and death. Objective To describe the severity of 2009 influenza A(H1N1) illness and the association with early antiviral treatment among pregnant women in the United States. Design, Setting, and Patients Surveillance of 2009 influenza A(H1N1) in pregnant women reported to the Centers for Disease Control and Prevention (CDC) with symptom onset from April through December 2009. Main Outcome Measures Severity of illness (hospitalizations, intensive care unit [ICU] admissions, and deaths) due to 2009 influenza A(H1N1) among pregnant women, stratified by timing of antiviral treatment and pregnancy trimester at symptom onset. Results 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%; relative risk [RR], 6.0; 95% confidence interval [CI], 3.5-10.6) 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%); Conclusions 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. JAMA. 2010;303(15):1517-1525 www.jama.com
 General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology

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