Pregnant women at more risk with H1N1

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Even though the 2009 influenza season, featuring the H1N1 pandemic, was largely a self-limited uncomplicated infection, pregnant women suffered increase risk of hospitalization and death. “Changes in the immune, cardiac, and respiratory systems are likely reasons that pregnant women are at increased risk for severe illness with influenza,” wrote the authors of a study released in the April 21 issue of JAMA.

Alicia M. Sisten, Ph.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues analyzed data on influenza cases of pregnant women reported to the CDC during the back half of 2009. The researchers focused on severity of illness as evidenced by hospitalizations, ICU care, and death from influenza A(H1N1), further detailed by timing of antiviral treatment and the women’s pregnancy trimester when symptoms first occurred.

During that period of 2009, a total of 788 cases of H1N1 among pregnant women were reported. Among those cases, 30 died representing 5% of all H1N1 deaths in this period. Among 509 hospitalized women, 115 or 22.6%, were admitted to an ICU. Pregnant women with treatment more than 4 days after symptom onset were six times more likely to be admitted to an ICU than those treated within two days after symptom onset.

“Pregnant women represent approximately 1% of the US population, yet they accounted for 5% of deaths from 2009 influenza A(H1N1) reported to the CDC. The data reported herein are consistent with previous studies that demonstrate that pregnant women with influenza are at increased risk of serious illness and death. In addition, delayed treatment of antiviral therapy was associated with more severe illness and death as previously shown for both seasonal influenza and 2009 influenza A(H1N1) monovalent vaccine and early treatment of women who present with possible 2009 influenza A(H1N1) with antiviral medications.”

Pregnant women should push past their reluctance for preventive treatment and get vaccinated. The sooner the better after symptom onset.

Source: Science Daily, JAMA


 
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