title: Influenza-like illness in hospitalized pregnant and postpartum women during the 2009-2010 H1N1 pandemic.
abstract: OBJECTIVE
  To estimate characteristics and outcomes of pregnant and immediately postpartum women hospitalized with influenza-like illness during the 2009-2010 influenza pandemic and the factors associated with more severe illness.
  
  
  METHODS
  An observational cohort in 28 hospitals of pregnant and postpartum (within 2 weeks of delivery) women hospitalized with influenza-like illness. Influenza-like illness was defined as clinical suspicion of influenza and either meeting the Centers for Disease Control and Prevention definition of influenza-like illness (fever 100.0°F or higher, cough, sore throat) or a positive influenza test.
  
  
  RESULTS
  Of 356 women meeting eligibility criteria, 35 (9.8%) were admitted to the intensive care unit (ICU) and four (1.1%) died. Two hundred eighteen women (61.2%) were in the third trimester and 10 (2.8%) were postpartum. More than half (55.3%) were admitted in October and 25.0% in November with rapidly decreasing numbers thereafter. Antiviral therapy was administered to 10.1% of the women before hospitalization and to 88.5% during hospitalization. Factors associated with an increased likelihood of ICU admission included cigarette smoking (29.4% compared with 13.4%; odds ratio [OR] 2.77, 95% confidence interval [CI] 1.19-6.45) and chronic hypertension (17.1% compared with 3.1%; OR 6.86, 95% CI 2.19-21.51). Antiviral treatment within 2 days of symptom onset decreased the likelihood of ICU admission (31.4% compared with 56.6%, OR 0.36, 95% CI 0.16-0.77).
  
  
  CONCLUSIONS
  Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency.
  
  
  METHODS
  II.
authors.affiliation: From the Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah; Brown University, Providence, Rhode Island; Oregon Health & Science University, Portland, Oregon; the University of Texas Southwestern Medical Center, Dallas, Texas; the University of Texas Medical Branch, Galveston, Texas; Northwestern University, Chicago, Illinois; Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio; Columbia University, New York, New York; the University of Alabama at Birmingham, Birmingham, Alabama; Wayne State University, Detroit, Michigan; the University of Texas Health Science Center at Houston, Houston, Texas; The Ohio State University, Columbus, Ohio; the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the University of Pittsburgh, Pittsburgh, Pennsylvania; the Medical University of South Carolina, Charleston, South Carolina; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Madeline Murguia
authors.initials: MM
authors.lastname: Rice
authors.forename: Brenna
authors.initials: B
authors.lastname: Anderson
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Tolosa
authors.forename: Jeanne
authors.initials: J
authors.lastname: Sheffield
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: George
authors.initials: G
authors.lastname: Saade
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.forename: Judette M
authors.initials: JM
authors.lastname: Louis
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Alan T N
authors.initials: ATN
authors.lastname: Tita
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Sean C
authors.initials: SC
authors.lastname: Blackwell
authors.forename: Mona
authors.initials: M
authors.lastname: Prasad
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Amber
authors.initials: A
authors.lastname: Naresh
authors.forename: J Peter
authors.initials: JP
authors.lastname: Van Dorsten
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology*; D007362:Intensive Care Units; D008428:Maternal Mortality; D058873:Pandemics; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D011645:Puerperal Infection / Q000453:epidemiology*; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents