OBJECTIVE: To describe the epidemiology of 2009 A/H1N1 influenza in critically ill pregnant women. DESIGN: Population based cohort study. SETTING: All intensive care units in Australia and New Zealand. PARTICIPANTS: All women with 2009 H1N1 influenza who were pregnant or recently post partum and admitted to an intensive care unit in Australia or New Zealand between 1 June and 31 August 2009. MAIN OUTCOME MEASURES: Maternal and neonatal mortality and morbidity. RESULTS: 64 pregnant or postpartum women admitted to an intensive care unit had confirmed 2009 H1N1 influenza. Compared with non-pregnant women of childbearing age, pregnant or postpartum women with 2009 H1N1 influenza were at increased risk of admission to an intensive care unit (relative risk 7.4, 95% confidence interval 5.5 to 10.0). This risk was 13-fold greater (13.2, 9.6 to 18.3) for women at 20 or more weeks' gestation. At the time of admission to an intensive care unit, 22 women (34%) were post partum and two had miscarried. 14 women (22%) gave birth during their stay in intensive care and 26 (41%) were discharged from an intensive care unit with ongoing pregnancy. All subsequently delivered. 44 women (69%) were mechanically ventilated. Of these, nine (14%) were treated with extracorporeal membrane oxygenation. Seven women (11%) died. Of 60 births after 20 weeks' gestation, four were stillbirths and three were infant deaths. 22 (39%) of the liveborn babies were preterm and 32 (57%) were admitted to a neonatal intensive care unit. Of 20 babies tested, two were positive for the 2009 H1N1 virus. CONCLUSIONS: Pregnancy is a risk factor for critical illness related to 2009 H1N1 influenza, which causes maternal and neonatal morbidity and mortality.
AN - 20299694 BT - BMJ (Clinical Research Edition) ET - 2010/03/20 LA - eng N1 - ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance SystemMulticenter StudyResearch Support, Non-U.S. Gov'tEnglandBMJ (Clinical research ed.)BMJ. 2010 Mar 18;340:c1279. doi: 10.1136/bmj.c1279. N2 -OBJECTIVE: To describe the epidemiology of 2009 A/H1N1 influenza in critically ill pregnant women. DESIGN: Population based cohort study. SETTING: All intensive care units in Australia and New Zealand. PARTICIPANTS: All women with 2009 H1N1 influenza who were pregnant or recently post partum and admitted to an intensive care unit in Australia or New Zealand between 1 June and 31 August 2009. MAIN OUTCOME MEASURES: Maternal and neonatal mortality and morbidity. RESULTS: 64 pregnant or postpartum women admitted to an intensive care unit had confirmed 2009 H1N1 influenza. Compared with non-pregnant women of childbearing age, pregnant or postpartum women with 2009 H1N1 influenza were at increased risk of admission to an intensive care unit (relative risk 7.4, 95% confidence interval 5.5 to 10.0). This risk was 13-fold greater (13.2, 9.6 to 18.3) for women at 20 or more weeks' gestation. At the time of admission to an intensive care unit, 22 women (34%) were post partum and two had miscarried. 14 women (22%) gave birth during their stay in intensive care and 26 (41%) were discharged from an intensive care unit with ongoing pregnancy. All subsequently delivered. 44 women (69%) were mechanically ventilated. Of these, nine (14%) were treated with extracorporeal membrane oxygenation. Seven women (11%) died. Of 60 births after 20 weeks' gestation, four were stillbirths and three were infant deaths. 22 (39%) of the liveborn babies were preterm and 32 (57%) were admitted to a neonatal intensive care unit. Of 20 babies tested, two were positive for the 2009 H1N1 virus. CONCLUSIONS: Pregnancy is a risk factor for critical illness related to 2009 H1N1 influenza, which causes maternal and neonatal morbidity and mortality.
PY - 2010 SN - 1468-5833 (Electronic)0959-535X (Linking) EP - c1279 T2 - BMJ (Clinical Research Edition) TI - Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study VL - 340 ER -