tetano
Editor, Senior Moderator
Obstet Gynecol. 2011 Sep;118(3):593-600.
Influenza-Like Illness in Hospitalized Pregnant and Postpartum Women During the 2009-2010 H1N1 Pandemic.
Varner MW, Rice MM, Anderson B, Tolosa JE, Sheffield J, Spong CY, Saade G, Peaceman AM, Louis JM, Wapner RJ, Tita AT, Sorokin Y, Blackwell SC, Prasad M, Thorp JM Jr, Naresh A, Van Dorsten JP; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU).
Source
From the Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah; Brown University, Providence, Rhode Island; Oregon Health & Science University, Portland, Oregon; the University of Texas Southwestern Medical Center, Dallas, Texas; the University of Texas Medical Branch, Galveston, Texas; Northwestern University, Chicago, Illinois; Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio; Columbia University, New York, New York; the University of Alabama at Birmingham, Birmingham, Alabama; Wayne State University, Detroit, Michigan; the University of Texas Health Science Center at Houston, Houston, Texas; The Ohio State University, Columbus, Ohio; the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the University of Pittsburgh, Pittsburgh, Pennsylvania; the Medical University of South Carolina, Charleston, South Carolina; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Abstract
OBJECTIVE:
To estimate characteristics and outcomes of pregnant and immediately postpartum women hospitalized with influenza-like illness during the 2009-2010 influenza pandemic and the factors associated with more severe illness.
METHODS:
An observational cohort in 28 hospitals of pregnant and postpartum (within 2 weeks of delivery) women hospitalized with influenza-like illness. Influenza-like illness was defined as clinical suspicion of influenza and either meeting the Centers for Disease Control and Prevention definition of influenza-like illness (fever 100.0?F or higher, cough, sore throat) or a positive influenza test.
RESULTS:
Of 356 women meeting eligibility criteria, 35 (9.8%) were admitted to the intensive care unit (ICU) and four (1.1%) died. Two hundred eighteen women (61.2%) were in the third trimester and 10 (2.8%) were postpartum. More than half (55.3%) were admitted in October and 25.0% in November with rapidly decreasing numbers thereafter. Antiviral therapy was administered to 10.1% of the women before hospitalization and to 88.5% during hospitalization. Factors associated with an increased likelihood of ICU admission included cigarette smoking (29.4% compared with 13.4%; odds ratio [OR] 2.77, 95% confidence interval [CI] 1.19-6.45) and chronic hypertension (17.1% compared with 3.1%; OR 6.86, 95% CI 2.19-21.51). Antiviral treatment within 2 days of symptom onset decreased the likelihood of ICU admission (31.4% compared with 56.6%, OR 0.36, 95% CI 0.16-0.77).
CONCLUSION:
Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency.
LEVEL OF EVIDENCE:
II.
PMID:
21860288
[PubMed - as supplied by publisher]
PMCID: PMC3160605
[Available on 2012/9/1]
http://www.ncbi.nlm.nih.gov/pubmed/21860288
Influenza-Like Illness in Hospitalized Pregnant and Postpartum Women During the 2009-2010 H1N1 Pandemic.
Varner MW, Rice MM, Anderson B, Tolosa JE, Sheffield J, Spong CY, Saade G, Peaceman AM, Louis JM, Wapner RJ, Tita AT, Sorokin Y, Blackwell SC, Prasad M, Thorp JM Jr, Naresh A, Van Dorsten JP; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU).
Source
From the Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah; Brown University, Providence, Rhode Island; Oregon Health & Science University, Portland, Oregon; the University of Texas Southwestern Medical Center, Dallas, Texas; the University of Texas Medical Branch, Galveston, Texas; Northwestern University, Chicago, Illinois; Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio; Columbia University, New York, New York; the University of Alabama at Birmingham, Birmingham, Alabama; Wayne State University, Detroit, Michigan; the University of Texas Health Science Center at Houston, Houston, Texas; The Ohio State University, Columbus, Ohio; the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the University of Pittsburgh, Pittsburgh, Pennsylvania; the Medical University of South Carolina, Charleston, South Carolina; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Abstract
OBJECTIVE:
To estimate characteristics and outcomes of pregnant and immediately postpartum women hospitalized with influenza-like illness during the 2009-2010 influenza pandemic and the factors associated with more severe illness.
METHODS:
An observational cohort in 28 hospitals of pregnant and postpartum (within 2 weeks of delivery) women hospitalized with influenza-like illness. Influenza-like illness was defined as clinical suspicion of influenza and either meeting the Centers for Disease Control and Prevention definition of influenza-like illness (fever 100.0?F or higher, cough, sore throat) or a positive influenza test.
RESULTS:
Of 356 women meeting eligibility criteria, 35 (9.8%) were admitted to the intensive care unit (ICU) and four (1.1%) died. Two hundred eighteen women (61.2%) were in the third trimester and 10 (2.8%) were postpartum. More than half (55.3%) were admitted in October and 25.0% in November with rapidly decreasing numbers thereafter. Antiviral therapy was administered to 10.1% of the women before hospitalization and to 88.5% during hospitalization. Factors associated with an increased likelihood of ICU admission included cigarette smoking (29.4% compared with 13.4%; odds ratio [OR] 2.77, 95% confidence interval [CI] 1.19-6.45) and chronic hypertension (17.1% compared with 3.1%; OR 6.86, 95% CI 2.19-21.51). Antiviral treatment within 2 days of symptom onset decreased the likelihood of ICU admission (31.4% compared with 56.6%, OR 0.36, 95% CI 0.16-0.77).
CONCLUSION:
Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency.
LEVEL OF EVIDENCE:
II.
PMID:
21860288
[PubMed - as supplied by publisher]
PMCID: PMC3160605
[Available on 2012/9/1]
http://www.ncbi.nlm.nih.gov/pubmed/21860288