Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study Academic Article uri icon

abstract

  • 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.

authors

  • Seppelt, I
  • Sullivan, Elizabeth
  • Bellomo, Rinaldo
  • Ellwood, David
  • Finfer, Simon
  • Howe, Belinda
  • Knight, Marian
  • McArthur, Colin
  • McDonnell, Nolan
  • McLintock, Clare
  • Morgan, Thomas John
  • Morrison, Siouxzy
  • Nguyen, Nhi
  • Peek, Michael John
  • Pollock, Wendy
  • Vaughan, Geraldine
  • Wang, Yueping Alex
  • Web, Steven AR
  • Pettila, V
  • Bailey, M
  • Cooper, DJ
  • Cretikos, M
  • Davies, AR
  • Finfer, S
  • Harrigan, PWJ
  • Hart, GK
  • Howe, B
  • Iredell, J
  • McArthur, C
  • Mitchell, I
  • Morrison, S
  • Nichol, A
  • Paterson, DL
  • Peake, S
  • Richards, B
  • Stephens, D
  • Turner, A
  • Yung, M
  • Homer, C
  • Pulver, LJ
  • Knight, M
  • Peek, MJ
  • Elliot, E
  • Ho, T
  • McDonnell, N
  • McLintock, C
  • Thompson, J
  • Zurynski, Y
  • Callaway, L
  • Welsh, A
  • Oats, J
  • Gupta, B
  • Hague, W
  • Pollock, W
  • Vaughan, G
  • Wang, YA
  • McKee, A
  • McGuinness, S
  • Parke, R
  • Whitley, A
  • Newby, L
  • Simmonds, C
  • Eastwood, G
  • Peck, L
  • Fletcher, J
  • Boschert, C
  • Smith, J
  • Bennett, G
  • Ong, L
  • Nand, K
  • Reece, G
  • Sara, T
  • Ernest, D
  • Eliott, S
  • Sidhu, J
  • Carroll, A
  • Richmond, S
  • Wenck, D
  • Bishop, G
  • Ashley, R
  • Crowfoot, E
  • Henderson, S
  • Mehrtens, J
  • Cretikos, M
  • Fizzell, J
  • Faithfull, S
  • Baynes, T
  • Bersten, A
  • Ryan, E
  • Scroggs, S
  • Blythe, D
  • Palermo, A
  • Bortz, P
  • Lodding, K
  • Mott, M
  • Vagg, S
  • Frengley, R
  • Haslam, A
  • La Pine, M
  • Bingham, T
  • Cavill, D
  • Jennings, B
  • Parr, M
  • Micallef, S
  • Chaplin, J
  • Gregory, K
  • Morgan, TJ
  • Presneill, J
  • Sutton, J
  • Horsley, C
  • Tai, J
  • Tilsley, A
  • Crozier, T
  • Galt, P
  • Reilly, M
  • Rockell, J
  • Hoyling, L
  • Nguyen, N
  • Weisbrodt, L
  • Bell, J
  • Flanagan, A
  • Laing, J
  • Duke, G
  • Parkes, M
  • Carr, J
  • Lambert, J
  • Boots, R
  • Callaway, L
  • Lassig-Smith, M
  • McLaine, J
  • Thomas, J
  • Winter, S
  • Barge, D
  • Caf, T
  • Harley, N
  • MacIsaac, C
  • Bird, S
  • Raper, R
  • Chamberlain, J
  • Gould, A
  • McEntaggart, G
  • Gattas, D
  • Rajbhandari, D
  • Rees, C
  • Baker, S
  • Bicknell, A
  • Roberts, B
  • Nair, P
  • Reynolds, C
  • Evans, J
  • Gordon, G
  • Jones, L
  • Radtke, S
  • Andrews, L
  • Elder, R
  • Hicks, P
  • Mackle, D
  • Boyd, R
  • Mudaliar, Y
  • Nayyar, V
  • Skelly, C
  • Stachowski, E
  • Sterba, M
  • Johnson, B
  • Hague, W
  • Robinson, J

publication date

  • March 18, 2010