WASHINGTON, DC—In 2009, pregnant women had a higher rate of hospitalization and greater risk of death from the H1N1 flu than the general population, according to a study in the August 8 issue of the British medical journal Lancet.

The data collected and analyzed by the Centers for Disease Control and Prevention are the most comprehensive available to date on the impact of this novel H1N1 flu virus among pregnant women. Accordingly, they have made recommendations for practitioners. “Clinicians who treat pregnant women should have a system in place for triaging pregnant women with influenza-like symptoms, and they should not delay in initiating appropriate antiviral therapy,” said CDC’s Dr Denise Jamieson, lead author of the study, in a statement. “Some clinicians hesitate when treating pregnant women with antiviral medications because of concerns for the developing fetus, but this is the wrong approach. It is critical that pregnant women, in particular, be treated promptly.”

The H1N1-related deaths of 6 pregnant women were reported to CDC between April 15 and June 16, 2009, representing 13% of the total 45 deaths reported to CDC during that time period. All were healthy prior to their H1N1 infection and subsequently developed primary viral pneumonia leadingtoacuterespiratorydistressrequiringmech-anicalventilation. All ofthe pregnantwomen forwhom H1N1 provedfatal didnot receiveantivirals quickly enough to benefit their treatment. As quoted above, CDC recommends that pregnant women with suspected or confirmed influenza infection receiveprompttreatmentwithantiviralmedication.

Based on past influenza pandemics and on seasonal influenza epidemics, pregnant women have increased rates of illness and death from influenza infection. However, despite recommendations from the Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists, seasonal flu vaccine coverage among pregnant women is less than 14%. CDC has posted clinical guidance for treatment and prophylaxis of pregnant women with suspected or confirmed pandemic H1N1 2009 influenza at http://www.cdc.gov.h1n1flu/clinician_pregnant.htm.

back to September articles