title: Obstetric, clinical, and perinatal implications of H1N1 viral infection during pregnancy.
abstract: OBJECTIVE
  To determine perinatal outcome and epidemiologic, clinical, and obstetric characteristics among pregnant women infected with the H1N1 virus admitted to a Brazilian university hospital.
  
  
  METHODS
  A cross-sectional study was conducted of pregnant women infected with H1N1 who were admitted to the University Hospital at the School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil, during the 2009 pandemic. Data were obtained via a questionnaire, which was administered during the hospital evaluation of patients' medical records.
  
  
  RESULTS
  Thirty-one patients were included in the study. Antiviral therapy was initiated within 48 hours of the onset of symptoms in 64.5% of cases. Infection with the H1N1 virus was associated with severe clinical complications in 22.6% of patients and adverse perinatal outcomes in 41.9% of cases. The rate of maternal and perinatal mortality was 9.7%. There was a statistically significant association between late treatment with oseltamivir and increase in systemic complications in pregnancy (odds ratio 22.80 [95% confidence interval, 2.20-235.65]; P=0.007).
  
  
  CONCLUSIONS
  Early treatment with oseltamivir may prevent serious complications associated with H1N1 infection in pregnant women but it does not affect perinatal outcome.
authors.affiliation: Department of Gynecology and Obstetrics, School of Medicine-Federal University of Mato Grosso do Sul (FAMED-UFMS), Campo Grande, Brazil. eafigueiro@uol.com.br
authors.forename: Ernesto A
authors.initials: EA
authors.lastname: Figueiró-Filho
authors.forename: Myrna L G
authors.initials: ML
authors.lastname: Oliveira
authors.forename: Maurício A
authors.initials: MA
authors.lastname: Pompilio
authors.forename: Silvia N O
authors.initials: SN
authors.lastname: Uehara
authors.forename: Lílian R
authors.initials: LR
authors.lastname: Coelho
authors.forename: Bruno A
authors.initials: BA
authors.lastname: De Souza
authors.forename: Ili
authors.initials: I
authors.lastname: Breda
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D008428:Maternal Mortality; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D054238:Perinatal Mortality; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011256:Pregnancy Outcome; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir