Pandemic influenza H1N1 2009 virus infection in pregnancy in Turkey.
OBJECTIVE
To describe the clinical characteristics of the pregnant women who were hospitalized in a tertiary referral hospital with pandemic influenza H1N1 2009 virus infection and neonatal outcomes from October 2009 to December 2009 during which the pandemic influenza cases peaked in Turkey.


METHODS
Twenty-five pregnant women who were hospitalized with influenza-like illness and who had laboratory confirmation for pandemic influenza H1N1 virus infection were evaluated prospectively.


RESULTS
Of the 25 patients, 4 (16%) were in the first trimester, 8 (32%) were in the second trimester, and 13 (52%) were in the third trimester. The median time from the onset of symptoms to the initiation of antiviral therapy was 1 day (range 1-9 days). Nineteen (76%) patients received oseltamivir treatment. It took 1.6 days on the average for the fever defervescence after the initiation of treatment or hospitalization. Of the 14 patients who underwent chest radiography, three had findings consistent with pneumonia. The mean duration of hospitalization was 4.8 days. Four women (16%) were admitted to an intensive care unit, but there were no maternal or neonatal deaths in this series. At the time of their H1N1 hospitalization, seven women delivered by cesarean at 33-40 weeks gestation, two vaginally at 38 weeks gestation, and two had an abortion at 10 weeks and 16 weeks of gestation, respectively. None of the infants had any evidence of influenza infection.


CONCLUSIONS
Pregnant women are at increased risk for complications from pandemic influenza H1N1 virus infection. Timely medical attention with early recourse to antiviral therapy is associated with a better outcome in H1N1-affected pregnant women.
Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey. sebnemsenozyer@yahoo.com
Sebnem
S
Ozyer
Serpil
S
Unlü
Sevki
S
Celen
Ozlem
O
Uzunlar
Sibel
S
Saygan
Filiz Akın
FA
Su
Mustafa
M
Beşli
Nuri
N
Danışman
Leyla
L
Mollamahmutoğlu
D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology*; D058873:Pandemics / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
D000998:Antiviral Agents