Pneumonia as a complication of pregnancy.
OBJECTIVE
To identify risk factors for the development of antepartum pneumonia and to describe maternal and perinatal outcome in pregnant women with pneumonia.


METHODS
The study group consisted of 59 women with antepartum pneumonia. Pneumonia was defined by the presence of lower respiratory tract symptoms, radiographic findings, no other source of infection, and at least two of the following: oral temperature > or =38 degrees C, white blood cell count > or =15,000/ml, auscultatory findings, and/or positive sputum cultures. For comparison, a control group (n = 118) of pregnant women was formed by selecting the first mother who delivered immediately before and after an index study subject.


RESULTS
Mothers in the study group were significantly more likely than women in the control group to have either a history of asthma (P = 0.022) or an admission hematocrit < or =30% (P < 0.001). Women with pneumonia were also more likely to receive a tocolytic agent (P < 0.001) and/or beta-methasone to enhance fetal lung maturity (P < 0.001). In addition, study subjects delivered at an earlier mean gestational age (P = 0.002) and had infants who weighed significantly less (P = 0.003) than mothers in the control group. Multivariate analysis indicated that women with asthma or anemia had more than a five-fold increase in the risk of developing pneumonia during pregnancy (P = 0.013), and mothers with pneumonia were significantly more likely to deliver before 34 weeks gestation (P = 0.04).


CONCLUSIONS
Pneumonia during pregnancy was associated with maternal anemia and asthma. In addition, preterm labor with tocolysis and/or beta-methasone was more common in women with pneumonia, and these women were more likely to deliver preterm and have low birthweight infants compared to women without pneumonia.
Munn
M B
MB
Department of Obstetrics and Gynecology, University of South Alabama, Mobile 36617, USA. Mmunn@jaguar1.usouthal.edu
Groome
L J
LJ
Atterbury
J L
JL
Baker
S L
SL
Hoff
C
C
D000740:Anemia / Q000150:complications; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications; D001623:Betamethasone / Q000627:therapeutic use; D001831:Body Temperature; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D015149:Tocolytic Agents / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D015149:Tocolytic Agents; D001623:Betamethasone