Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States

被引：700

作者：

Siston, Alicia M. ^{[2
,3
]}

Rasmussen, Sonja A. ^{[1
]}

Honein, Margaret A. ^{[1
]}

Fry, Alicia M. ^{[3
]}

Seib, Katherine

Callaghan, William M. ^{[4
]}

Louie, Janice ^{[5
]}

Doyle, Timothy J. ^{[6
]}

Crockett, Molly ^{[7
]}

Lynfield, Ruth ^{[8
]}

Moore, Zack ^{[9
]}

Wiedeman, Caleb ^{[10
]}

Anand, Madhu ^{[11
]}

Tabony, Laura ^{[12
]}

Nielsen, Carrie F. ^{[2
,13
]}

Waller, Kirsten ^{[14
]}

Page, Shannon ^{[15
]}

Thompson, Jeannie M. ^{[16
]}

Avery, Catherine ^{[17
]}

Springs, Chasisity Brown ^{[18
]}

Jones, Timothy ^{[19
]}

Williams, Jennifer L.

Newsome, Kim

Finelli, Lyn ^{[3
]}

Jamieson, Denise J. ^{[4
]}

机构：

[1] Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA 30333 USA

[2] Ctr Dis Control & Prevent, Epidem Intelligence Serv, Atlanta, GA 30333 USA

[3] Ctr Dis Control & Prevent, Natl Ctr Immunizat & Resp Dis, Atlanta, GA 30333 USA

[4] Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA

[5] Calif Dept Publ Hlth, Richmond, CA USA

[6] Florida Dept Hlth, Tallahassee, FL USA

[7] Massachusetts Dept Publ Hlth, Boston, MA USA

[8] Minnesota Dept Hlth, St Paul, MN USA

[9] N Carolina Dept Hlth & Human Serv, Raleigh, NC USA

[10] Arizona Dept Hlth Serv, Phoenix, AZ 85007 USA

[11] New York State Dept Hlth, Albany, NY 12237 USA

[12] Texas Dept State Hlth Serv, Austin, TX USA

[13] Wisconsin Dept Hlth Serv, Madison, WI USA

[14] Penn Dept Hlth, Harrisburg, PA 17108 USA

[15] Ohio Dept Hlth, Columbus, OH 43266 USA

[16] Oklahoma Dept Hlth, Oklahoma City, OK USA

[17] New Mexico Dept Hlth, Santa Fe, NM USA

[18] S Carolina Dept Hlth & Environm Control, Columbia, SC 29201 USA

[19] Tennessee Dept Hlth, Nashville, TN USA

来源：

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2010年 / 303卷 / 15期

关键词：

A H1N1 VIRUS; CRITICALLY-ILL PATIENTS; OSELTAMIVIR TREATMENT; ASIAN INFLUENZA; INFECTION; IMPACT; SAFETY; SENSITIVITY; VACCINATION; PREVENTION;

D O I：

10.1001/jama.2010.479

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Context Early data on pandemic 2009 influenza A(H1N1) suggest pregnant women are at increased risk of hospitalization and death. Objective To describe the severity of 2009 influenza A(H1N1) illness and the association with early antiviral treatment among pregnant women in the United States. Design, Setting, and Patients Surveillance of 2009 influenza A(H1N1) in pregnant women reported to the Centers for Disease Control and Prevention (CDC) with symptom onset from April through December 2009. Main Outcome Measures Severity of illness (hospitalizations, intensive care unit [ICU] admissions, and deaths) due to 2009 influenza A(H1N1) among pregnant women, stratified by timing of antiviral treatment and pregnancy trimester at symptom onset. Results We received reports on 788 pregnant women in the United States with 2009 influenza A(H1N1) with symptom onset from April through August 2009. Among those, 30 died (5% of all reported 2009 influenza A[ H1N1] influenza deaths in this period). Among 509 hospitalized women, 115 (22.6%) were admitted to an ICU. Pregnant women with treatment more than 4 days after symptom onset were more likely to be admitted to an ICU (56.9% vs 9.4%; relative risk [RR], 6.0; 95% confidence interval [CI], 3.5-10.6) than those treated within 2 days after symptom onset. Only 1 death occurred in a patient who received treatment within 2 days of symptom onset. Updating these data with the CDC's continued surveillance of ICU admissions and deaths among pregnant women with symptom onset through December 31, 2009, identified an additional 165 women for a total of 280 women who were admitted to ICUs, 56 of whom died. Among the deaths, 4 occurred in the first trimester (7.1%), 15 in the second (26.8%), and 36 in the third (64.3%); Conclusions Pregnant women had a disproportionately high risk of mortality due to 2009 influenza A(H1N1). Among pregnant women with 2009 influenza A(H1N1) influenza reported to the CDC, early antiviral treatment appeared to be associated with fewer admissions to an ICU and fewer deaths. JAMA. 2010;303(15):1517-1525 www.jama.com

引用

页码：1517 / 1525

页数：9

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