H1N1 2009 influenza virus infection during pregnancy in the USA
H1N1 2009 influenza virus infection during pregnancy in the USA
复制标题
DOI：
10.1016/s0140-6736(09)61304-0
复制
发表时间：
2009-08-08
期刊：
影响因子：
168.9
通讯作者：
Olsen, Sonja J.
中科院分区：
文献类型：
--
作者：
Jamieson, Denise J.;Honein, Margaret A.;Olsen, Sonja J.
背景：2009年h1n1流感大流行病毒已被确定为在美国和世界范围内广泛暴发发热性呼吸道感染的原因。我们总结了在本次疫情暴发的第一个月在美国发现的感染大流行性H1N1病毒的孕妇病例，以及在疫情暴发的前两个月与该病毒相关的死亡病例。方法在孕妇感染的初步报告后，美国疾病控制和预防中心（CDC）开始系统地收集有关美国大流行性H1N1病毒感染孕妇病例和死亡的额外信息，作为加强监测的一部分。通过实时逆转录酶PCR或病毒培养将确诊病例定义为实验室确诊的H1N1大流行性病毒感染的急性呼吸道疾病；可能病例定义为患有急性发热性呼吸道疾病的人，他对甲型流感呈阳性，但对H1和H3呈阴性。我们使用2007年人口普查数据得出的人口估计值来计算住院率和发病率。从2009年4月15日至5月18日，13个州向疾病预防控制中心报告了34例确诊或可能的孕妇H1N1大流行病例。11名（32%）妇女住院。在疫情爆发的第一个月，孕妇因大流行性H1N1流感病毒感染而入院的估计率高于一般人群（每10万名孕妇中有0.32人，95% CI 0.13-0.52 vs每10万名高危人群中有0.076人，95% CI 0.07-0.09）。2009年4月15日至6月16日期间，美国疾病控制与预防中心收到了6例孕妇死亡报告；所有患者均患有肺炎和随后需要机械通气的急性呼吸窘迫综合征。孕妇感染H1N1大流行性流感病毒后出现并发症的风险可能增加。这些数据支持目前的建议，即立即用抗流感药物治疗感染H1N1流感病毒的孕妇。资助美国疾病预防控制中心。
Background Pandemic HlN1 2009 influenza virus has been identified as the cause of a widespread outbreak of febrile respiratory infection in the USA and worldwide. We summarised cases of infection with pandemic H1N1 virus in pregnant women identified in the USA during the first month of the present outbreak, and deaths associated with this virus during the first 2 months of the outbreak.Methods After initial reports of infection in pregnant women, the US Centers for Disease Control and Prevention (CDC) began systematically collecting additional information about cases and deaths in pregnant women in the USA with pandemic H1N1 virus infection as part of enhanced surveillance. A confirmed case was defined as an acute respiratory illness with laboratory-confirmed pandemic H1N1 virus infection by real-time reverse-transcriptase PCR or viral culture; a probable case was defined as a person with an acute febrile respiratory illness who was positive for influenza A, but negative for H1 and H3. We used population estimates derived from the 2007 census data to calculate rates of admission to hospital and illness.Findings From April 15 to May 18, 2009, 34 confirmed or probable cases of pandemic H1N1 in pregnant women were reported to CDC from 13 states. 11 (32%) women were admitted to hospital. The estimated rate of admission for pandemic H1N1 influenza virus infection in pregnant women during the first month of the outbreak was higher than it was in the general population (0.32 per 100000 pregnant women, 95% CI 0.13-0.52 vs 0.076 per 100 000 population at risk, 95% CI 0.07-0.09). Between April 15 and June 16, 2009, six deaths in pregnant women were reported to the CDC; all were in women who had developed pneumonia and subsequent acute respiratory distress syndrome requiring mechanical ventilation.Interpretation Pregnant women might be at increased risk for complications from pandemic H1N1 virus infection. These data lend support to the present recommendation to promptly treat pregnant women with H1N1 influenza virus infection with anti-influenza drugs.Funding US CDC.