Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study.
Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study.
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DOI：
10.1136/bmj.c1279
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发表时间：
2010-03-18
期刊：
影响因子：
--
通讯作者：
ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System
中科院分区：
文献类型：
--
作者：
ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System
目的了解2009年甲型H1N1流感在危重症孕妇中的流行病学特征。设计基于人群的队列研究。设置澳大利亚和新西兰的所有重症监护病房。所有2009年6月1日至2009年8月31日期间在澳大利亚或新西兰怀孕或近期产后并入住重症监护室的2009年H1N1流感患者。主要结果测量产妇和新生儿死亡率和发病率。结果64名孕妇或产后妇女入住重症监护室确诊为2009年H1N1流感。与未怀孕的育龄妇女相比，感染2009年H1N1流感的孕妇或产后妇女入住重症监护室的风险增加（相对风险7.4，95%置信区间5.5至10.0）。对于妊娠20周或以上的妇女，这种风险高13倍（13.2，9.6至18.3）。在进入重症监护室时，22名妇女（34%）是产后妇女，2名流产。14名妇女（22%）在重症监护期间分娩，26名妇女（41%）在继续妊娠的情况下从重症监护室出院。随后全部交付。44名女性（69%）接受了机械通气。其中，9例（14%）接受了体外膜肺氧合治疗。7名妇女（11%）死亡。妊娠20周后出生的60名婴儿中，有4名死产，3名婴儿死亡。22例（39%）活产婴儿为早产，32例（57%）入住新生儿重症监护室。在20名接受检测的婴儿中，有两名对2009年H1N1病毒呈阳性。结论妊娠是2009年甲型H1N1流感相关危重症的危险因素，导致孕产妇和新生儿的发病率和死亡率。
Objective To describe the epidemiology of 2009 A/H1N1 influenza in critically ill pregnant women. Design Population based cohort study. Setting All intensive care units in Australia and New Zealand. Participants All women with 2009 H1N1 influenza who were pregnant or recently post partum and admitted to an intensive care unit in Australia or New Zealand between 1 June and 31 August 2009. Main outcome measures Maternal and neonatal mortality and morbidity. Results 64 pregnant or postpartum women admitted to an intensive care unit had confirmed 2009 H1N1 influenza. Compared with non-pregnant women of childbearing age, pregnant or postpartum women with 2009 H1N1 influenza were at increased risk of admission to an intensive care unit (relative risk 7.4, 95% confidence interval 5.5 to 10.0). This risk was 13-fold greater (13.2, 9.6 to 18.3) for women at 20 or more weeks’ gestation. At the time of admission to an intensive care unit, 22 women (34%) were post partum and two had miscarried. 14 women (22%) gave birth during their stay in intensive care and 26 (41%) were discharged from an intensive care unit with ongoing pregnancy. All subsequently delivered. 44 women (69%) were mechanically ventilated. Of these, nine (14%) were treated with extracorporeal membrane oxygenation. Seven women (11%) died. Of 60 births after 20 weeks’ gestation, four were stillbirths and three were infant deaths. 22 (39%) of the liveborn babies were preterm and 32 (57%) were admitted to a neonatal intensive care unit. Of 20 babies tested, two were positive for the 2009 H1N1 virus. Conclusions Pregnancy is a risk factor for critical illness related to 2009 H1N1 influenza, which causes maternal and neonatal morbidity and mortality.
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影响因子：
168.9
作者：
Jamieson, Denise J.;Honein, Margaret A.;Olsen, Sonja J.
通讯作者：
Olsen, Sonja J.
影响因子：
11.4
作者：
Chan, A;Sage, LC
通讯作者：
Sage, LC
影响因子：
--
作者：
Andersen, AMN;Wohlfahrt, J;Melbye, M
通讯作者：
Melbye, M
DOI：
10.1016/0002-9378(59)90570-8
发表时间：
1959-01-01
影响因子：
9.8
作者：
FREEMAN, DW
通讯作者：
FREEMAN, DW
影响因子：
158.5
作者：
Louie, Janice K.;Acosta, Meileen;Honein, Margaret A.
通讯作者：
Honein, Margaret A.