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H1N1 Associated With Serious Health Risks for Pregnant Women CHICAGO -- May 24, 2010 -- Pregnant women who contract influenza A(H1N1) are at risk for obstetrical complications including fetal distress, premature delivery, emergency Cesarean delivery, and fetal death, according to a study published in the May 24 issue of Archives of Internal Medicine. "Little data have been reported regarding the impact of H1N1 on pregnant patients or the gestational fetus, and published reports have been conflicting," the authors wrote. The study also noted that during prior seasonal influenza epidemics and pandemics, pregnant women have been reported to have increased hospitalisation rates, increased illness and mortality, but no increase in birth defects. Historically, pregnant patients during the flu pandemics of 1918 and 1957 had high mortality rates. "Because obstetrical patients make up a vulnerable population, it is crucial to characterise in them the severity and course of H1N1," wrote Andrew C. Miller, MD, State University of New York Downstate Medical Center, and Kings County Hospital Center, Brooklyn, New York, and colleagues. The researchers analysed data from 18 patients, with an average age of 27, who were admitted to 2 urban academic medical centres with a diagnosis of H1N1 from May 18 to June 24, 2009. The results were then compared with published reports of the H1N1 outbreak and reports of flu pandemics of 1918 and 1957. All patients were treated with oseltamivir phosphate beginning on the day of admission. Three of the 18 patients were admitted to the intensive care unit, and 7 patients delivered during their hospital stay -- 6 prematurely. Of these 6 premature births, 5 involved fetal distress and 4 were delivered via emergency Cesarean delivery. There were no congenital birth defects identified; however, 2 fetal deaths were recorded. No maternal deaths were reported. "Little data are available regarding fetal outcomes and mortality rates among H1N1-infected mothers," the authors wrote. "Of the 18 patients in this series, 1 had a spontaneous abortion and one died postnatally from complications of extreme prematurity and sepsis." Based on the findings of the observational study, the authors concluded that "H1N1 poses a serious health threat to pregnant patients." The authors also concluded that fetal distress necessitating emergency Cesarean delivery may result in significant illness; however, this study showed an absence of maternal deaths as compared with prior study results. According to the authors' conclusions, "early antiviral treatment may improve maternal outcomes." SOURCE: Archives of Internal Medicine E-mail this page to a friend or colleague! To print, use this version