Influenza-like illness in hospitalized pregnant and postpartum women during the 2009-2010 H1N1 pandemic

Michael W. Varner, Madeline Murguia Rice, Brenna Anderson, Jorge E. Tolosa, Jeanne Sheffield, Catherine Y. Spong, George Saade, Alan M. Peaceman, Judette M. Louis, Ronald J. Wapner, Alan T N Tita, Yoram Sorokin, Sean C. Blackwell, Mona Prasad, John M. Thorp, Amber Naresh, J. Peter Van Dorsten

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective: To estimate characteristics and outcomes of pregnant and immediately postpartum women hospitalized with influenza-like illness during the 2009-2010 influenza pandemic and the factors associated with more severe illness. Methods: An observational cohort in 28 hospitals of pregnant and postpartum (within 2 weeks of delivery) women hospitalized with influenza-like illness. Influenza-like illness was defined as clinical suspicion of influenza and either meeting the Centers for Disease Control and Prevention definition of influenza-like illness (fever 100.0°F or higher, cough, sore throat) or a positive influenza test. Results: Of 356 women meeting eligibility criteria, 35 (9.8%) were admitted to the intensive care unit (ICU) and four (1.1%) died. Two hundred eighteen women (61.2%) were in the third trimester and 10 (2.8%) were postpartum. More than half (55.3%) were admitted in October and 25.0% in November with rapidly decreasing numbers thereafter. Antiviral therapy was administered to 10.1% of the women before hospitalization and to 88.5% during hospitalization. Factors associated with an increased likelihood of ICU admission included cigarette smoking (29.4% compared with 13.4%; odds ratio [OR] 2.77, 95% confidence interval [CI] 1.19-6.45) and chronic hypertension (17.1% compared with 3.1%; OR 6.86, 95% CI 2.19-21.51). Antiviral treatment within 2 days of symptom onset decreased the likelihood of ICU admission (31.4% compared with 56.6%, OR 0.36, 95% CI 0.16-0.77). Conclusion: Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency.

Original languageEnglish (US)
Pages (from-to)593-600
Number of pages8
JournalObstetrics and Gynecology
Volume118
Issue number3
DOIs
StatePublished - Sep 2011

Fingerprint

Pandemics
Postpartum Period
Human Influenza
Pregnant Women
Intensive Care Units
Antiviral Agents
Hospitalization
Odds Ratio
Confidence Intervals
Smoking
Hypertension
Pharyngitis
Third Pregnancy Trimester
Centers for Disease Control and Prevention (U.S.)
Cough
Comorbidity
Fever
Therapeutics
Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Varner, M. W., Rice, M. M., Anderson, B., Tolosa, J. E., Sheffield, J., Spong, C. Y., ... Van Dorsten, J. P. (2011). Influenza-like illness in hospitalized pregnant and postpartum women during the 2009-2010 H1N1 pandemic. Obstetrics and Gynecology, 118(3), 593-600. https://doi.org/10.1097/AOG.0b013e318229e484

Influenza-like illness in hospitalized pregnant and postpartum women during the 2009-2010 H1N1 pandemic. / Varner, Michael W.; Rice, Madeline Murguia; Anderson, Brenna; Tolosa, Jorge E.; Sheffield, Jeanne; Spong, Catherine Y.; Saade, George; Peaceman, Alan M.; Louis, Judette M.; Wapner, Ronald J.; Tita, Alan T N; Sorokin, Yoram; Blackwell, Sean C.; Prasad, Mona; Thorp, John M.; Naresh, Amber; Van Dorsten, J. Peter.

In: Obstetrics and Gynecology, Vol. 118, No. 3, 09.2011, p. 593-600.

Research output: Contribution to journalArticle

Varner, MW, Rice, MM, Anderson, B, Tolosa, JE, Sheffield, J, Spong, CY, Saade, G, Peaceman, AM, Louis, JM, Wapner, RJ, Tita, ATN, Sorokin, Y, Blackwell, SC, Prasad, M, Thorp, JM, Naresh, A & Van Dorsten, JP 2011, 'Influenza-like illness in hospitalized pregnant and postpartum women during the 2009-2010 H1N1 pandemic', Obstetrics and Gynecology, vol. 118, no. 3, pp. 593-600. https://doi.org/10.1097/AOG.0b013e318229e484
Varner, Michael W. ; Rice, Madeline Murguia ; Anderson, Brenna ; Tolosa, Jorge E. ; Sheffield, Jeanne ; Spong, Catherine Y. ; Saade, George ; Peaceman, Alan M. ; Louis, Judette M. ; Wapner, Ronald J. ; Tita, Alan T N ; Sorokin, Yoram ; Blackwell, Sean C. ; Prasad, Mona ; Thorp, John M. ; Naresh, Amber ; Van Dorsten, J. Peter. / Influenza-like illness in hospitalized pregnant and postpartum women during the 2009-2010 H1N1 pandemic. In: Obstetrics and Gynecology. 2011 ; Vol. 118, No. 3. pp. 593-600.
@article{4c8af57bfdb2495b8247723ccdfa8bc2,
title = "Influenza-like illness in hospitalized pregnant and postpartum women during the 2009-2010 H1N1 pandemic",
abstract = "Objective: To estimate characteristics and outcomes of pregnant and immediately postpartum women hospitalized with influenza-like illness during the 2009-2010 influenza pandemic and the factors associated with more severe illness. Methods: An observational cohort in 28 hospitals of pregnant and postpartum (within 2 weeks of delivery) women hospitalized with influenza-like illness. Influenza-like illness was defined as clinical suspicion of influenza and either meeting the Centers for Disease Control and Prevention definition of influenza-like illness (fever 100.0°F or higher, cough, sore throat) or a positive influenza test. Results: Of 356 women meeting eligibility criteria, 35 (9.8{\%}) were admitted to the intensive care unit (ICU) and four (1.1{\%}) died. Two hundred eighteen women (61.2{\%}) were in the third trimester and 10 (2.8{\%}) were postpartum. More than half (55.3{\%}) were admitted in October and 25.0{\%} in November with rapidly decreasing numbers thereafter. Antiviral therapy was administered to 10.1{\%} of the women before hospitalization and to 88.5{\%} during hospitalization. Factors associated with an increased likelihood of ICU admission included cigarette smoking (29.4{\%} compared with 13.4{\%}; odds ratio [OR] 2.77, 95{\%} confidence interval [CI] 1.19-6.45) and chronic hypertension (17.1{\%} compared with 3.1{\%}; OR 6.86, 95{\%} CI 2.19-21.51). Antiviral treatment within 2 days of symptom onset decreased the likelihood of ICU admission (31.4{\%} compared with 56.6{\%}, OR 0.36, 95{\%} CI 0.16-0.77). Conclusion: Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency.",
author = "Varner, {Michael W.} and Rice, {Madeline Murguia} and Brenna Anderson and Tolosa, {Jorge E.} and Jeanne Sheffield and Spong, {Catherine Y.} and George Saade and Peaceman, {Alan M.} and Louis, {Judette M.} and Wapner, {Ronald J.} and Tita, {Alan T N} and Yoram Sorokin and Blackwell, {Sean C.} and Mona Prasad and Thorp, {John M.} and Amber Naresh and {Van Dorsten}, {J. Peter}",
year = "2011",
month = "9",
doi = "10.1097/AOG.0b013e318229e484",
language = "English (US)",
volume = "118",
pages = "593--600",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Influenza-like illness in hospitalized pregnant and postpartum women during the 2009-2010 H1N1 pandemic

AU - Varner, Michael W.

AU - Rice, Madeline Murguia

AU - Anderson, Brenna

AU - Tolosa, Jorge E.

AU - Sheffield, Jeanne

AU - Spong, Catherine Y.

AU - Saade, George

AU - Peaceman, Alan M.

AU - Louis, Judette M.

AU - Wapner, Ronald J.

AU - Tita, Alan T N

AU - Sorokin, Yoram

AU - Blackwell, Sean C.

AU - Prasad, Mona

AU - Thorp, John M.

AU - Naresh, Amber

AU - Van Dorsten, J. Peter

PY - 2011/9

Y1 - 2011/9

N2 - Objective: To estimate characteristics and outcomes of pregnant and immediately postpartum women hospitalized with influenza-like illness during the 2009-2010 influenza pandemic and the factors associated with more severe illness. Methods: An observational cohort in 28 hospitals of pregnant and postpartum (within 2 weeks of delivery) women hospitalized with influenza-like illness. Influenza-like illness was defined as clinical suspicion of influenza and either meeting the Centers for Disease Control and Prevention definition of influenza-like illness (fever 100.0°F or higher, cough, sore throat) or a positive influenza test. Results: Of 356 women meeting eligibility criteria, 35 (9.8%) were admitted to the intensive care unit (ICU) and four (1.1%) died. Two hundred eighteen women (61.2%) were in the third trimester and 10 (2.8%) were postpartum. More than half (55.3%) were admitted in October and 25.0% in November with rapidly decreasing numbers thereafter. Antiviral therapy was administered to 10.1% of the women before hospitalization and to 88.5% during hospitalization. Factors associated with an increased likelihood of ICU admission included cigarette smoking (29.4% compared with 13.4%; odds ratio [OR] 2.77, 95% confidence interval [CI] 1.19-6.45) and chronic hypertension (17.1% compared with 3.1%; OR 6.86, 95% CI 2.19-21.51). Antiviral treatment within 2 days of symptom onset decreased the likelihood of ICU admission (31.4% compared with 56.6%, OR 0.36, 95% CI 0.16-0.77). Conclusion: Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency.

AB - Objective: To estimate characteristics and outcomes of pregnant and immediately postpartum women hospitalized with influenza-like illness during the 2009-2010 influenza pandemic and the factors associated with more severe illness. Methods: An observational cohort in 28 hospitals of pregnant and postpartum (within 2 weeks of delivery) women hospitalized with influenza-like illness. Influenza-like illness was defined as clinical suspicion of influenza and either meeting the Centers for Disease Control and Prevention definition of influenza-like illness (fever 100.0°F or higher, cough, sore throat) or a positive influenza test. Results: Of 356 women meeting eligibility criteria, 35 (9.8%) were admitted to the intensive care unit (ICU) and four (1.1%) died. Two hundred eighteen women (61.2%) were in the third trimester and 10 (2.8%) were postpartum. More than half (55.3%) were admitted in October and 25.0% in November with rapidly decreasing numbers thereafter. Antiviral therapy was administered to 10.1% of the women before hospitalization and to 88.5% during hospitalization. Factors associated with an increased likelihood of ICU admission included cigarette smoking (29.4% compared with 13.4%; odds ratio [OR] 2.77, 95% confidence interval [CI] 1.19-6.45) and chronic hypertension (17.1% compared with 3.1%; OR 6.86, 95% CI 2.19-21.51). Antiviral treatment within 2 days of symptom onset decreased the likelihood of ICU admission (31.4% compared with 56.6%, OR 0.36, 95% CI 0.16-0.77). Conclusion: Comorbidities, including chronic hypertension and smoking in pregnancy, increase the likelihood of ICU admission in influenza-like illness hospitalizations, whereas early antiviral treatment may reduce its frequency.

UR - http://www.scopus.com/inward/record.url?scp=80052139413&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052139413&partnerID=8YFLogxK

U2 - 10.1097/AOG.0b013e318229e484

DO - 10.1097/AOG.0b013e318229e484

M3 - Article

VL - 118

SP - 593

EP - 600

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 3

ER -