title: Clinical profile & outcome of H1N1 infected pregnant women in a tertiary care teaching hospital of northern India.
abstract: OBJECTIVE
  H1N1 influenza is a recognized cause of febrile respiratory infection worldwide. There are not many studies to show its impact on pregnancy. In the present study we aimed to assess clinical characteristics, obstetric and perinatal outcome of pregnant women with H1N1 infection.
  
  
  METHODS
  A retrospective observational study was conducted at a tertiary care teaching hospital in New Delhi, India. A total of 24 pregnant women microbiologically positive for H1N1 were included. Maternal characteristics and outcome were recorded. Perinatal outcome which was defined as presence of any of the indicators such as abortion, preterm delivery, intrauterine death and neo natal death was noted.
  
  
  RESULTS
  The mean age of the study group was 25.2 ± 3 yr with a mean gestational age of 34.9 ± 4.6 wk. Six patients (25%) had associated co-morbidities. Nine patients (37.5%) presented within 48 h of onset of symptoms and 15 (62.5%) reported after 48 h. In 17 (70.83%) patients treatment was delayed by >48 h. ICU admission was needed in 20.8 per cent patients and mortality rates was 8.3 per cent. There were seven cases of adverse perinatal outcome.
  
  
  CONCLUSIONS
  The presenting symptoms of pregnant women with H1N1 were similar to that of general population. Acquiring infection in late trimester, late initiation of antiviral treatment and presence of co-morbid illness were high risk factors for developing critical illness. Pregnant women with suspected H1N1 influenza should be started on antiviral therapy at the earliest. This is likely to help reduce the ICU admission rates and mortalities in this group of women.
authors.affiliation: Department of Obstetrics & Gynaecology, VMMC & Safdarjang Hospital, New Delhi, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Singhal
authors.forename: Nivedita
authors.initials: N
authors.lastname: Sarda
authors.forename: Renu
authors.initials: R
authors.lastname: Arora
authors.forename: Nikky
authors.initials: N
authors.lastname: Punia
authors.forename: Anil
authors.initials: A
authors.lastname: Jain
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D063128:Tertiary Health Care