The comparative clinical course of pregnant and non-pregnant women hospitalised with influenza A(H1N1)pdm09 infection
The comparative clinical course of pregnant and non-pregnant women hospitalised with influenza A(H1N1)pdm09 infection
Introduction: The Influenza Clinical Information Network (FLU-CIN) was established to gather detailed clinical and epidemiological information about patients with laboratory confirmed A(H1N1)pdm09 infection in UK hospitals. This report focuses on the clinical course and outcomes of infection in pregnancy.
Methods: A standardised data extraction form was used to obtain detailed clinical information from hospital case notes and electronic records, for patients with PCR-confirmed A(H1N1)pdm09 infection admitted to 13 sentinel hospitals in five clinical 'hubs' and a further 62 non-sentinel hospitals, between 11th May 2009 and 31st January 2010.Outcomes were compared for pregnant and non-pregnant women aged 15-44 years, using univariate and multivariable techniques.
Results: Of the 395 women aged 15-44 years, 82 (21%) were pregnant; 73 (89%) in the second or third trimester. Pregnant women were significantly less likely to exhibit severe respiratory distress at initial assessment (OR?=?0.49 (95% CI: 0.30-0.82)), require supplemental oxygen on admission (OR?=?0.40 (95% CI: 0.20-0.80)), or have underlying co-morbidities (p-trend <0.001). However, they were equally likely to be admitted to high dependency (Level 2) or intensive care (Level 3) and/or to die, after adjustment for potential confounders (adj. OR?=?0.93 (95% CI: 0.46-1.92). Of 11 pregnant women needing Level 2/3 care, 10 required mechanical ventilation and three died.
Conclusions: Since the expected prevalence of pregnancy in the source population was 6%, our data suggest that pregnancy greatly increased the likelihood of hospital admission with A(H1N1)pdm09. Pregnant women were less likely than non-pregnant women to have respiratory distress on admission, but severe outcomes were equally likely in both groups.
e41638
Dolan, Gayle P.
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Myles, Puja R.
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Brett, Stephen J.
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Enstone, Joanne E.
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Read, Robert C.
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Openshaw, Peter J.M.
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Semple, Malcolm G.
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Lim, Wei Shen
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Taylor, Bruce L.
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McMenamin, James
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Nicholson, Karl G.
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Bannister, Barbara
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Nguyen-Van-Tam, Jonathan S.
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3 August 2012
Dolan, Gayle P.
42f0171d-67dd-4a46-bfb0-ecbe29360025
Myles, Puja R.
123c952c-b5b3-47bf-8e67-1d50bb40b114
Brett, Stephen J.
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Enstone, Joanne E.
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Read, Robert C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Openshaw, Peter J.M.
43fb682a-04c9-4fc2-8404-674823f966a3
Semple, Malcolm G.
15b207df-e044-4078-9b40-1af17b800ab1
Lim, Wei Shen
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Taylor, Bruce L.
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McMenamin, James
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Nicholson, Karl G.
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Bannister, Barbara
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Nguyen-Van-Tam, Jonathan S.
1aac2164-f614-4c82-87f9-e123817bf128
Dolan, Gayle P., Myles, Puja R., Brett, Stephen J., Enstone, Joanne E., Read, Robert C., Openshaw, Peter J.M., Semple, Malcolm G., Lim, Wei Shen, Taylor, Bruce L., McMenamin, James, Nicholson, Karl G., Bannister, Barbara and Nguyen-Van-Tam, Jonathan S.
(2012)
The comparative clinical course of pregnant and non-pregnant women hospitalised with influenza A(H1N1)pdm09 infection.
PLoS ONE, 7 (8), .
(doi:10.1371/journal.pone.0041638).
(PMID:22870239)
Abstract
Introduction: The Influenza Clinical Information Network (FLU-CIN) was established to gather detailed clinical and epidemiological information about patients with laboratory confirmed A(H1N1)pdm09 infection in UK hospitals. This report focuses on the clinical course and outcomes of infection in pregnancy.
Methods: A standardised data extraction form was used to obtain detailed clinical information from hospital case notes and electronic records, for patients with PCR-confirmed A(H1N1)pdm09 infection admitted to 13 sentinel hospitals in five clinical 'hubs' and a further 62 non-sentinel hospitals, between 11th May 2009 and 31st January 2010.Outcomes were compared for pregnant and non-pregnant women aged 15-44 years, using univariate and multivariable techniques.
Results: Of the 395 women aged 15-44 years, 82 (21%) were pregnant; 73 (89%) in the second or third trimester. Pregnant women were significantly less likely to exhibit severe respiratory distress at initial assessment (OR?=?0.49 (95% CI: 0.30-0.82)), require supplemental oxygen on admission (OR?=?0.40 (95% CI: 0.20-0.80)), or have underlying co-morbidities (p-trend <0.001). However, they were equally likely to be admitted to high dependency (Level 2) or intensive care (Level 3) and/or to die, after adjustment for potential confounders (adj. OR?=?0.93 (95% CI: 0.46-1.92). Of 11 pregnant women needing Level 2/3 care, 10 required mechanical ventilation and three died.
Conclusions: Since the expected prevalence of pregnancy in the source population was 6%, our data suggest that pregnancy greatly increased the likelihood of hospital admission with A(H1N1)pdm09. Pregnant women were less likely than non-pregnant women to have respiratory distress on admission, but severe outcomes were equally likely in both groups.
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Published date: 3 August 2012
Organisations:
Clinical & Experimental Sciences
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Local EPrints ID: 346732
URI: http://eprints.soton.ac.uk/id/eprint/346732
ISSN: 1932-6203
PURE UUID: 4e8e0ad0-a0b4-4702-a790-f2c7cf9a3f17
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Date deposited: 16 Jan 2013 14:24
Last modified: 15 Mar 2024 03:42
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Contributors
Author:
Gayle P. Dolan
Author:
Puja R. Myles
Author:
Stephen J. Brett
Author:
Joanne E. Enstone
Author:
Peter J.M. Openshaw
Author:
Malcolm G. Semple
Author:
Wei Shen Lim
Author:
Bruce L. Taylor
Author:
James McMenamin
Author:
Karl G. Nicholson
Author:
Barbara Bannister
Author:
Jonathan S. Nguyen-Van-Tam
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