Early Antivirals Decrease H1N1 Mortality in Pregnant Women

Also linked to fewer ICU admissions; pregnant women made up 5 percent of H1N1 deaths in 2009
By Lindsey Marcellin
HealthDay Reporter

TUESDAY, April 20 (HealthDay News) -- Pregnant women with influenza A(H1N1) have a high risk of mortality, although early antiviral treatment is associated with fewer intensive care unit (ICU) admissions and lower mortality, according to research published in the April 21 issue of the Journal of the American Medical Association.

Alicia M. Siston, Ph.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues used CDC surveillance data to identify pregnant women diagnosed with H1N1 between April and December 2009. Severity of illness was measured by determining whether a woman had been hospitalized, required ICU admission, or died of her illness.

The researchers found that a majority of the women diagnosed from April to August (509 of 788) were hospitalized, and 22.6 percent of this group were admitted to an ICU. Thirty women died, accounting for 5 percent of all reported H1N1-related deaths during the period. Women who received antiviral treatment later than four days after symptom onset had six times the risk of being admitted to an ICU compared with those who received antiviral treatment within two days. Additional surveillance data obtained through December identified 165 pregnant women admitted to the ICU, with an additional 26 deaths. The deaths occurred mostly in the second trimester (26.8 percent) and third trimester (64.3 percent).

"Pregnant women represent approximately 1 percent of the U.S. population, yet they accounted for 5 percent of U.S. deaths. 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," the authors write. "Our analysis supports current public health recommendations for pregnant women that include vaccination with 2009 influenza A(H1N1) monovalent vaccine and early treatment of women who present with possible 2009 influenza A(H1N1) with antiviral medications."

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