title: H1N1 influenza pandemic and maternal mortality in Antioquia, Colombia.
abstract: OBJECTIVE
  To evaluate the impact of the H1N1 influenza pandemic on maternal mortality in the province of Antioquia, Colombia, in 2009.
  
  
  METHODS
  The present study was a descriptive, retrospective, cross-sectional study of maternal deaths in Antioquia in 2009 caused by H1N1-related pneumonia. The study formed part of the epidemiologic surveillance process undertaken by the Health and Social Protection Directorate of Antioquia and the particular healthcare institutions involved in the cases.
  
  
  RESULTS
  In 2009, there were 42 maternal deaths in Antioquia, corresponding to a maternal mortality ratio of 46 per 100 000 live births. Ten deaths were due to pneumonia, 9 of which occurred after the H1N1 outbreak was first reported in early 2009. In 3 cases, the women were confirmed to have H1N1 virus infection, and the remainder fulfilled probable case criteria. The main factors contributing to the deaths were underestimation of H1N1 symptoms, and delays in administration of antiviral medication and in hospitalization.
  
  
  CONCLUSIONS
  For the population subgroup of pregnant women in Antioquia, it is crucial to remain alert regarding H1N1 virus infection, guaranteeing patients adequate monitoring and/or timely administration of immunization, medication, and hospitalization.
authors.affiliation: Department of Obstetrics and Gynecology, University of Antioquia School of Medicine, Center Nacer in Sexual and Reproductive Health, Medellín, Colombia.
authors.forename: Jesús
authors.initials: J
authors.lastname: Velásquez
authors.forename: Gladis
authors.initials: G
authors.lastname: Vélez
authors.forename: John
authors.initials: J
authors.lastname: Zuleta
authors.forename: Francisco
authors.initials: F
authors.lastname: Franco
authors.forename: Joaquín
authors.initials: J
authors.lastname: Gómez
mesh_terms: D000328:Adult; D003105:Colombia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D007114:Immunization; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000401:mortality* / Q000517:prevention & control; D008427:Maternal Health Services; D008428:Maternal Mortality; D058873:Pandemics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000401:mortality* / Q000517:prevention & control; D012189:Retrospective Studies; D055815:Young Adult