Pandemic Influenza A (H1N1) in Non-vaccinated, Pregnant Women in Spain (2009–2010)
- First Online:
- 208 Downloads
The aim of this study was to investigate the main characteristics of non-vaccinated pregnant women who were hospitalised for influenza A (H1N1) pdm09 pandemic versus pregnant women hospitalised for non-influenza-related reasons in Spain, and to characterise the clinical presentation of the disease in this population to facilitate early diagnosis and future action programmes. Understanding influenza infection during pregnancy is important as pregnant women are a high-risk population for increased morbidity from influenza infection. We investigated the socio-demographic and clinical features of 51 non-vaccinated, pregnant women infected with the pandemic influenza A (H1N1) virus in Spain (cases) and compared them to 114 controls (non-vaccinated and non-infected pregnant women) aged 15–44 years. Substantial and significant odd ratios (ORs) for pandemic influenza A (H1N1) were found for the pregnant women who were obese compared with controls (body mass index > 30) (OR 3.03; 95 % confidence intervals 1.13–8.11). The more prevalent symptoms observed in pandemic influenza-infected pregnant women were high temperature, cough (82.4 %), malaise (80.5 %), myalgia (56.1 %), and headaches (54.9 %). Our results suggest that the initial symptoms and risk factors for infection of pregnant women with the influenza A (H1N1) pdm09 virus are similar to the symptoms and risk factors for seasonal influenza, which make early diagnosis difficult, and reinforces the need to identify and protect high-risk groups.
KeywordsInfluenza A (H1N1) Pregnancy Pandemic Symptomatology Clinical characteristics
- 4.Makele, M. J., Puhakka, T., Ruuskanen, O., Leinonen, M., Saikku, P., Kimpimäki, M., et al. (1998). Viruses and bacteria in the etiology of common cold. Journal of Clinical Microbiology, 36(2), 539–542.Google Scholar
- 9.Centers for Disease Control and Prevention. (2009). Novel influenza A (N1H1) virus infections in three pregnant women—United States. Morbidity and Mortality Weekly Report, 58, 497–500.Google Scholar
- 10.Centers for Disease Control and Prevention. (2009). Hospitalized patients with novel influenza A (H1N1) virus infection—California. Morbidity and Mortality Weekly Report, 58, 536–541.Google Scholar
- 17.Hanslik, T., Boelle, P., & Flahault, A. (2010). Preliminary estimation of risk factors for admission to intensive care units and for death in patients infected with A (H1N1) 2009 influenza virus, France, 2009–2010. PLoS Currents, RRN1150. doi:10.1371/currents.RRN1150.
- 18.Vaillant, L., La Ruche, G., Tarantola, A., & Barboza, P. (2009). Epidemiology of fatal cases associated with pandemic H1N1 influenza 2009. Euro Surveilancel, 14(33), 19309.Google Scholar
- 19.World Health Organization (WHO). Available at: http://www.who.int/mediacentre/news/notes/2010/sage_20100528/es/.
- 22.World Health Organization. (2009). Transmission dynamics and impact of pandemic influenza A (H1N1) 2009 virus. Weekly Epidemiological Record, 84, 481–484.Google Scholar
- 25.Domínguez, A., Alonso, J., Astray, J., Baricot, M., Cantón, R., Castilla, J., et al. (2011). Factores de riesgo de hospitalización por gripe A (H1N1)2009 y efectividad de intervenciones farmacológicas y no farmacológicas en su prevención. Estudio de casos y controles. Revista Española de Salud Pública, 85, 3–15.PubMedGoogle Scholar
- 27.Van Kerkhove, M. D., Vandemaele, K. A., Shinde, V., Jaramillo-Gutierrez, G., Koukounari, A., Donnelly, C. A., et al. (2011). Risk factors for severe outcomes following 2009 influenza A (H1N1) infection: A global pooled analysis. PLoS Medicine, 8(7), e1001053.PubMedCentralPubMedCrossRefGoogle Scholar
- 28.Maraví-Poma, E., Martin-Loeches, I., Regidor, E., Laplaza, C., Cambra, K., Aldunate, S., et al. (2011). Severe 2009 H1N1 influenza in pregnant women in Spain. Criticat Care Medicine, 39, 5.Google Scholar
- 31.Dodds, L., McNeil, S. A., Fell, D. B., Allen, V. M., Coombs, A., Scott, J., et al. (2007). Impact of influenza exposure on rates of hospital admissions and physician visits because of respiratory illness among pregnant women. Canadian Medical Association Journal, 176(4), 463–468.PubMedCentralPubMedCrossRefGoogle Scholar
- 32.Ozyer, S., Unlü, S., Celen, S., Uzunlar, O., Saygan, S., Su, F. A., et al. (2011). Pandemic influenza H1N1 2009 virus infection in pregnancy in Turkey. Taiwan Journal of Obstetrics and Gynecology, 170(3), 333–338.Google Scholar
- 33.Baker, M. G., Wilson, N., Huang, Q. S., Paine, S., Lopez, L., Bandaranayake, D., et al. (2009). Pandemic influenza A (H1N1)v in New Zealand: The experience from April to August 2009. Euro Surveillance, 14, 34.Google Scholar
- 34.Wenger, J. D., Castrodale, L. J., Bruden, D. L., Keck, J. W., Zulz, T., Bruce, M. G., et al. (2011). Pandemic influenza A H1N1 in Alaska: Temporal and geographic characteristics of spread and increased risk of hospitalization among Alaska Native and Asian/Pacific Islander people. The Journal of Infectious Diseases, 203, 828–837.CrossRefGoogle Scholar
- 35.Chen, C. L., Xiao, L., Wang, Q. L., Zhang, J., & Li, K. (2010). Ethnic differences in susceptibilities to A (H1N1) flu: an epidemic parameter indicating a weak viral virulence. African Journal of Biotechnology, 9, 589–592.Google Scholar
- 36.Archer, B., Cohen, C., Naidoo, D., Thomas, J., Makunga, C., Blumberg, L., et al. (2009). Interim report on pandemic H1N1 influenza virus infections in South Africa, April to October 2009: Epidemiology and factors associated with fatal cases. Euro Surveillance, 14(42), 19369.Google Scholar
- 38.Yates, L., Pierce, M., Stephens, S., Mill, A. C., Spark, P., Kurinczuk, J. J., et al. (2010). Influenza A/H1N1v in pregnancy: an investigation of the characteristics and management of affected women and the relationship to pregnancy outcomes for mother and infant. Health Technology Assessment, 14(34), 109–182.PubMedGoogle Scholar