Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study

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dc.contributor.authorANZIC Influenza Investigators
dc.contributor.authorAustralasian Maternity Outcomes Surveillance System
dc.date.accessioned2016-01-28T23:31:51Z
dc.date.available2016-01-28T23:31:51Z
dc.date.issued2010-03-19
dc.date.updated2016-02-24T10:42:01Z
dc.description.abstractOBJECTIVE 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.
dc.description.sponsorshipThe ANZIC Influenza Investigators registry is supported by the Department of Health and Ageing, Commonwealth Government of Australia; New South Wales Health, Government of New South Wales; Department of Health, Government of Victoria; the Australian and New Zealand Intensive Care Research Centre; the Australian and New Zealand Intensive Care Society; and an unrestricted grant from CSL, Melbourne, Victoria. The Australasian Maternity Outcomes Surveillance System is supported by National Health and Medical Research Council (Australia) project grant, No 510298.en_AU
dc.identifier.issn0959-8138en_AU
dc.identifier.urihttp://hdl.handle.net/1885/96094
dc.publisherBMJ Publishing Group
dc.relationhttp://purl.org/au-research/grants/nhmrc/510298
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
dc.sourceBMJ (Clinical research ed.)
dc.subjectadolescent
dc.subjectadult
dc.subjectaustralia
dc.subjectcohort studies
dc.subjectcritical illness
dc.subjectfemale
dc.subjecthumans
dc.subjectinfluenza, human
dc.subjectintensive care
dc.subjectnew zealand
dc.subjectpregnancy
dc.subjectpregnancy complications, infectious
dc.subjectpregnancy outcome
dc.subjectprenatal care
dc.subjectrisk factors
dc.subjectyoung adult
dc.subjectinfluenza a virus, h1n1 subtype
dc.titleCritical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study
dc.typeJournal article
local.bibliographicCitation.issue340
local.bibliographicCitation.lastpage6
local.bibliographicCitation.startpagec1279en_AU
local.contributor.affiliationSeppelt, Ian, Nepean Hospital, Australiaen_AU
local.contributor.affiliationSullivan, Elizabeth A, University of New South Wales , Australiaen_AU
local.contributor.affiliationBellomo, Rinaldo, Monash University, Australiaen_AU
local.contributor.affiliationEllwood, David, College of Medicine, Biology and Environment, CMBE ANU Medical School, ANU Medical School, The Australian National Universityen_AU
local.contributor.affiliationFinfer, Simon, University of Sydney, Australiaen_AU
local.contributor.affiliationHowe, Belinda, Monash University, Australiaen_AU
local.contributor.affiliationKnight, Marian, University of Oxford, United Kingdomen_AU
local.contributor.affiliationMcArthur, Colin, Auckland City Hospital , New Zealanden_AU
local.contributor.affiliationMcDonnell, Nolan, King Edward Memorial Hospital for Women, Australiaen_AU
local.contributor.affiliationMcLintock , Clare, Auckland City Hospital, New Zealanden_AU
local.contributor.affiliationMorgan, Thomas John, Mater Health Services, Australiaen_AU
local.contributor.affiliationMorrison, Siouxzy, Monash University, Australiaen_AU
local.contributor.affiliationNguyen, Nhi, Nepean Hospital and Sydney Medical School, Australiaen_AU
local.contributor.affiliationPeek, Michael , University of Sydney, Australiaen_AU
local.contributor.affiliationPollock, Wendy, University of New South Wales, Australiaen_AU
local.contributor.affiliationVaughan, Geraldine, University of New South Wales, Australiaen_AU
local.contributor.affiliationWang, Yueping Alex, University of New South Wales , Australiaen_AU
local.contributor.affiliationWebb, Steven, Royal Perth Hospital, Australiaen_AU
local.contributor.authoremaild.ellwood@griffith.edu.auen_AU
local.contributor.authoruidU4032417en_AU
local.description.notesImported from ARIESen_AU
local.identifier.absfor110309en_AU
local.identifier.absfor111499en_AU
local.identifier.ariespublicationu4201517xPUB284en_AU
local.identifier.citationvolume340en_AU
local.identifier.doi10.1136/bmj.c1279en_AU
local.identifier.essn1756-1833en_AU
local.identifier.scopusID2-s2.0-77950562637
local.identifier.uidSubmittedByu3488905en_AU
local.publisher.urlhttp://www.bmj.com/company/en_AU
local.type.statusPublished Versionen_AU

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