Influenza A/H1N1 (2009) infection in pregnancy--an Asian perspective

BJOG. 2010 Apr;117(5):551-6. doi: 10.1111/j.1471-0528.2010.02522.x. Epub 2010 Feb 10.

Abstract

Objective: To describe the characteristics of an obstetric population with influenza A/H1N1 (2009) infection, with a focus on the need for hospitalisation and complications.

Design: Cohort study.

Setting: Tertiary referral centre.

Population: Two hundred and eleven pregnant women with influenza A/H1N1 (2009) infection diagnosed by nasopharyngeal swab polymerase chain reaction (PCR).

Methods: Obstetric patients presenting to our centre were recruited and followed up. Data collected included demographic and clinical information.

Main outcome measures: H1N1 and pregnancy complications, and hospitalisation needs.

Results: The median age of the cohort was 29.0 years (range 16-42 years), the median gestation at referral was 23.0 weeks (range 4-38 weeks), the median time interval between illness onset and presentation was 2.0 days (range 1-7 days), and the median time interval between illness onset and commencement of oseltamivir was 2.0 days (range 1-11 days). Hospital admission was significantly associated with the presence of co-morbidity (OR 4.14, 95% CI 1.82-9.37, P = 0.0001), breathlessness (OR 5.2, 95% CI 2.19-12.41, P = 0.0003) and sore throat (OR 0.35, 95% CI 0.16-0.73, P = 0.005). There were two cases of pneumonia complicating H1N1 infection, but no mortality. Nine cases developed pregnancy complications. All women recovered.

Conclusions: The need for hospitalisation was significantly associated with breathlessness and co-morbidity. There was minimal morbidity and no mortality observed. We attribute this to early presentation, diagnosis and treatment.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Antiviral Agents / administration & dosage
  • Cohort Studies
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Influenza A Virus, H1N1 Subtype*
  • Influenza, Human / complications
  • Influenza, Human / ethnology
  • Influenza, Human / therapy*
  • Oseltamivir / administration & dosage
  • Pregnancy
  • Pregnancy Complications, Infectious / ethnology
  • Pregnancy Complications, Infectious / therapy*
  • Prenatal Care / methods
  • Prospective Studies
  • Singapore
  • Time Factors
  • Young Adult
  • Zanamivir / administration & dosage

Substances

  • Antiviral Agents
  • Oseltamivir
  • Zanamivir