Prognosis of 2009 A(H1N1) influenza in hospitalized pregnant women in a context of early diagnosis and antiviral therapy.
BACKGROUND
Initial reports suggested that novel A(H1N1) influenza virus (2009 A[H1N1]v) infection was significantly more severe in pregnant than in non-pregnant women. In Spain, antiviral therapy was recommended for pregnant women from the beginning of the 2009 pandemic.


METHODS
The prospective cohort study included consecutive pregnant and non-pregnant women of reproductive age with a proven diagnosis of 2009 A(H1N1)v admitted to any of the 13 participating Spanish hospitals between 12 June and 10 November 2009.


RESULTS
In total, 98 pregnant and 112 non-pregnant women with proven 2009 A(H1N1)v hospitalized during the study period were included. Influenza was more severe among non-pregnant patients than pregnant patients with respect to outcomes of both intensive care unit admission (18% versus 2%; P<0.001) and death (5 versus 0; P=0.06). Pregnant women had fewer associated comorbid conditions other than pregnancy (18% versus 44%; P<0.001); they were also admitted earlier than non-pregnant women (median days since onset of symptoms: 2 versus 3; P<0.001) and a higher percentage received early antiviral therapy (41% versus 28%; P=0.03). Neither a multivariate nor a matched cohort analysis found pregnancy to be associated with greater severity than that associated with hospitalized, seriously ill non-pregnant women.


CONCLUSIONS
2009 A(H1N1)v influenza was not associated with worse outcomes in hospitalized pregnant women compared with non-pregnant ones of reproductive age in a context of early diagnosis and antiviral therapy.
Hospital Universitario La Paz - IDIPAZ, Madrid, Spain.
José Ramón
JR
Paño-Pardo
Jesús
J
Rodríguez-Baño
Nuria
N
Martínez-Sánchez
Diego
D
Viasus
M Carmen
MC
Fariñas
María
M
Leyes
Francisco
F
López-Medrano
Jerónimo
J
Pachón
Julián
J
Torre-Cisneros
José Antonio
JA
Oteo
Tomás
T
Pumarola
Mercedes
M
García-Gasalla
Lucía
L
Ortega
Ferrán
F
Segura
Jordi
J
Carratalá
D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human; D008875:Middle Aged; D053139:Oseltamivir / Q000008:administration & dosage / Q000627:therapeutic use*; D058873:Pandemics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
D000998:Antiviral Agents; D053139:Oseltamivir