Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study
Identifieur interne : 002264 ( Istex/Corpus ); précédent : 002263; suivant : 002265Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study
Auteurs :Source :
- BMJ [ 0959-8138 ] ; 2010.
English descriptors
- Teeft :
- Antiviral, Antiviral drugs, Antiviral treatment, Anzic, Anzic influenza investigators, Anzic influenza investigators registry, Apgar score, Australasian maternity outcomes surveillance system, Australian bureau, Available data, Available registrations, Birth outcomes, Birth weight, Blood loss, Body mass index, Caesarean, Caesarean section, Caesarean sections, Care research centre, Care society, Care unit, Coexisting illness, Cohort study, Confidence interval, Confidential enquiries, Congenital heart disease, Critical illness, Current pregnancy, Distress syndrome, Emergency caesarean section, Endotracheal intubation, Essential hypertension, Extracorporeal, Extracorporeal membrane oxygenation, Fetal, Fetal loss, Fetal lung maturation, Fetal wellbeing, Gestation, Higher risk, Influenza, Influenza investigators, Influenza symptoms, Influenza syndromes, Intensive care, Intensive care management, Intensive care unit, Intensive care unit post partum, Intensive care units, Islander, Kingdom rcog press, Liveborn, Liveborn babies, Maternal, Maternal deaths, Maternal haemodynamic instability, Maternal hypoxia, Median, Neonatal, Neonatal outcomes, Observational studies, Obstet gynecol, Obstetric, Obstetrical problem, Ongoing pregnancy, Oxygenation, Pacific islander women, Partum, Perinatal, Perinatal deaths, Perinatal outcomes, Perinatal statistics unit, Post partum, Postpartum, Postpartum haemorrhage, Postpartum women, Pregnancy, Pregnant women, Preterm delivery, Range days, Relative risk, Research table, Risk factor, Seasonal influenza, Special care nursery, Stillbirth, Study period, Surgical delivery, Syndrome, Torres strait islanders, Total number, Trials group, Viral pneumonitis, Women weeks, Zealand, Zealand ministry.
Abstract
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.
Url:
DOI: 10.1136/bmj.c1279
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ISTEX:558732F739111153CE6A4712E22405B18CA0047CLe document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study</title></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:558732F739111153CE6A4712E22405B18CA0047C</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1136/bmj.c1279</idno><idno type="url">https://api.istex.fr/ark:/67375/NVC-BW4Q1Q7H-6/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">002264</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002264</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study</title></analytic><monogr></monogr><series><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2010">2010</date><biblScope unit="volume">340</biblScope></imprint><idno type="ISSN">0959-8138</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Antiviral</term><term>Antiviral drugs</term><term>Antiviral treatment</term><term>Anzic</term><term>Anzic influenza investigators</term><term>Anzic influenza investigators registry</term><term>Apgar score</term><term>Australasian maternity outcomes surveillance system</term><term>Australian bureau</term><term>Available data</term><term>Available registrations</term><term>Birth outcomes</term><term>Birth weight</term><term>Blood loss</term><term>Body mass index</term><term>Caesarean</term><term>Caesarean section</term><term>Caesarean sections</term><term>Care research centre</term><term>Care society</term><term>Care unit</term><term>Coexisting illness</term><term>Cohort study</term><term>Confidence interval</term><term>Confidential enquiries</term><term>Congenital heart disease</term><term>Critical illness</term><term>Current pregnancy</term><term>Distress syndrome</term><term>Emergency caesarean section</term><term>Endotracheal intubation</term><term>Essential hypertension</term><term>Extracorporeal</term><term>Extracorporeal membrane oxygenation</term><term>Fetal</term><term>Fetal loss</term><term>Fetal lung maturation</term><term>Fetal wellbeing</term><term>Gestation</term><term>Higher risk</term><term>Influenza</term><term>Influenza investigators</term><term>Influenza symptoms</term><term>Influenza syndromes</term><term>Intensive care</term><term>Intensive care management</term><term>Intensive care unit</term><term>Intensive care unit post partum</term><term>Intensive care units</term><term>Islander</term><term>Kingdom rcog press</term><term>Liveborn</term><term>Liveborn babies</term><term>Maternal</term><term>Maternal deaths</term><term>Maternal haemodynamic instability</term><term>Maternal hypoxia</term><term>Median</term><term>Neonatal</term><term>Neonatal outcomes</term><term>Observational studies</term><term>Obstet gynecol</term><term>Obstetric</term><term>Obstetrical problem</term><term>Ongoing pregnancy</term><term>Oxygenation</term><term>Pacific islander women</term><term>Partum</term><term>Perinatal</term><term>Perinatal deaths</term><term>Perinatal outcomes</term><term>Perinatal statistics unit</term><term>Post partum</term><term>Postpartum</term><term>Postpartum haemorrhage</term><term>Postpartum women</term><term>Pregnancy</term><term>Pregnant women</term><term>Preterm delivery</term><term>Range days</term><term>Relative risk</term><term>Research table</term><term>Risk factor</term><term>Seasonal influenza</term><term>Special care nursery</term><term>Stillbirth</term><term>Study period</term><term>Surgical delivery</term><term>Syndrome</term><term>Torres strait islanders</term><term>Total number</term><term>Trials group</term><term>Viral pneumonitis</term><term>Women weeks</term><term>Zealand</term><term>Zealand ministry</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">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.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>intensive care unit</json:string><json:string>gestation</json:string><json:string>postpartum</json:string><json:string>partum</json:string><json:string>pregnant women</json:string><json:string>postpartum women</json:string><json:string>influenza</json:string><json:string>perinatal</json:string><json:string>post partum</json:string><json:string>maternal deaths</json:string><json:string>fetal</json:string><json:string>antiviral</json:string><json:string>extracorporeal</json:string><json:string>obstetric</json:string><json:string>anzic</json:string><json:string>critical illness</json:string><json:string>stillbirth</json:string><json:string>oxygenation</json:string><json:string>caesarean</json:string><json:string>median</json:string><json:string>liveborn</json:string><json:string>islander</json:string><json:string>extracorporeal membrane oxygenation</json:string><json:string>australian bureau</json:string><json:string>intensive care</json:string><json:string>neonatal</json:string><json:string>ongoing pregnancy</json:string><json:string>pregnancy</json:string><json:string>maternal hypoxia</json:string><json:string>relative risk</json:string><json:string>coexisting illness</json:string><json:string>distress syndrome</json:string><json:string>antiviral treatment</json:string><json:string>care unit</json:string><json:string>zealand</json:string><json:string>fetal lung maturation</json:string><json:string>birth weight</json:string><json:string>perinatal statistics unit</json:string><json:string>special care nursery</json:string><json:string>neonatal outcomes</json:string><json:string>influenza investigators</json:string><json:string>influenza symptoms</json:string><json:string>liveborn babies</json:string><json:string>observational studies</json:string><json:string>confidential enquiries</json:string><json:string>perinatal outcomes</json:string><json:string>range days</json:string><json:string>body mass index</json:string><json:string>risk factor</json:string><json:string>seasonal influenza</json:string><json:string>intensive care units</json:string><json:string>confidence interval</json:string><json:string>caesarean section</json:string><json:string>trials group</json:string><json:string>maternal</json:string><json:string>syndrome</json:string><json:string>kingdom rcog press</json:string><json:string>anzic influenza investigators</json:string><json:string>total number</json:string><json:string>pacific islander women</json:string><json:string>zealand ministry</json:string><json:string>maternal haemodynamic instability</json:string><json:string>study period</json:string><json:string>women weeks</json:string><json:string>current pregnancy</json:string><json:string>postpartum haemorrhage</json:string><json:string>blood loss</json:string><json:string>influenza syndromes</json:string><json:string>torres strait islanders</json:string><json:string>intensive care management</json:string><json:string>congenital heart disease</json:string><json:string>essential hypertension</json:string><json:string>viral pneumonitis</json:string><json:string>birth outcomes</json:string><json:string>obstetrical problem</json:string><json:string>research table</json:string><json:string>fetal loss</json:string><json:string>antiviral drugs</json:string><json:string>cohort study</json:string><json:string>available data</json:string><json:string>emergency caesarean section</json:string><json:string>fetal wellbeing</json:string><json:string>available registrations</json:string><json:string>caesarean sections</json:string><json:string>endotracheal intubation</json:string><json:string>higher risk</json:string><json:string>perinatal deaths</json:string><json:string>preterm delivery</json:string><json:string>anzic influenza investigators registry</json:string><json:string>care research centre</json:string><json:string>australasian maternity outcomes surveillance system</json:string><json:string>care society</json:string><json:string>obstet gynecol</json:string><json:string>surgical delivery</json:string><json:string>intensive care unit post partum</json:string><json:string>apgar score</json:string></teeft></keywords><articleId><json:string>sepi742908</json:string></articleId><arkIstex>ark:/67375/NVC-BW4Q1Q7H-6</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>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.</abstract><qualityIndicators><score>9.521</score><pdfWordCount>4521</pdfWordCount><pdfCharCount>29433</pdfCharCount><pdfVersion>1.6</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595 x 794 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>275</abstractWordCount><abstractCharCount>1728</abstractCharCount><keywordCount>0</keywordCount></qualityIndicators><title>Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study</title><pmid><json:string>20299694</json:string></pmid><corporate><json:item><name>The ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System</name><affiliations><json:string>Correspondence to: I Seppelt, Department of Intensive Care Medicine, Nepean Hospital, PO Box 63, Penrith, NSW 2751, Sydney, Australia seppelt@med.usyd.edu.au</json:string></affiliations></json:item></corporate><genre><json:string>research-article</json:string></genre><host><title>BMJ</title><language><json:string>unknown</json:string></language><issn><json:string>0959-8138</json:string></issn><eissn><json:string>1468-5833</json:string></eissn><publisherId><json:string>bmj</json:string></publisherId><volume>340</volume><genre><json:string>journal</json:string></genre><subject><json:item><value>Infectious diseases</value></json:item><json:item><value>Epidemiologic studies</value></json:item><json:item><value>Pregnancy</value></json:item><json:item><value>Reproductive medicine</value></json:item><json:item><value>Child health</value></json:item><json:item><value>Neonatal and paediatric intensive care</value></json:item><json:item><value>Neonatal health</value></json:item></subject></host><namedEntities><unitex><date><json:string>2009</json:string><json:string>2700</json:string><json:string>2010-03-18</json:string><json:string>5500</json:string><json:string>2007</json:string><json:string>2008</json:string></date><geogName><json:string>Torres</json:string></geogName><orgName><json:string>Australian Bureau of Statistics and Statistics</json:string><json:string>Department of Intensive Care Medicine, Nepean Hospital, PO Box</json:string><json:string>Australian and New Zealand Intensive Care</json:string><json:string>Australian and New Zealand Intensive Care Society Clinical Trials Group</json:string><json:string>United Kingdom Obstetric Surveillance System</json:string><json:string>Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne</json:string><json:string>RESEARCH Critical</json:string><json:string>Department of Health, Government of Victoria</json:string><json:string>Department of Health and Ageing</json:string><json:string>Australia and New Zealand</json:string><json:string>Australian and New Zealand Intensive Care Society</json:string><json:string>ANZIC Research Centre, the Australasian Society for Infectious Diseases Clinical Trials Group, the Paediatric Study Group of the ANZ IC Society, and the ANZIC Society Centre for Outcome and Resource</json:string><json:string>New Zealand Ministry of Health</json:string><json:string>Australian and New Zealand Intensive Care Research Centre</json:string><json:string>RESEARCH Table</json:string><json:string>Australian Bureau of Statistics</json:string><json:string>RESEARCH Pregnant</json:string><json:string>National Health and Medical Research</json:string><json:string>Australia and New Zealand Extracorporeal Membrane Oxygenation</json:string><json:string>UK Obstetric Surveillance System</json:string><json:string>ANZIC</json:string><json:string>Reproductive Epidemiology Research Unit, University of New South Wales, Sydney, Australia</json:string><json:string>Melbourne</json:string><json:string>CSL</json:string><json:string>Victoria</json:string></orgName><orgName_funder><json:string>Melbourne</json:string><json:string>CSL</json:string><json:string>Victoria</json:string></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Ville Pettilä</json:string><json:string>The</json:string><json:string>Giles W. Maternal</json:string><json:string>A. Deaths</json:string><json:string>Impact</json:string></persName><placeName><json:string>Australia</json:string><json:string>Ethnicity</json:string><json:string>Canberra</json:string><json:string>Wales</json:string><json:string>New Zealand</json:string><json:string>United Kingdom</json:string></placeName><ref_url><json:string>http://search.stats.govt.nz/nav/ct</json:string></ref_url><ref_bibl><json:string>Australia 2003</json:string><json:string>Australia 2008</json:string><json:string>Ministry of Health, 2009</json:string><json:string>AIHW National Perinatal Statistics Unit, 2008</json:string><json:string>Australia 2000</json:string><json:string>Australia 19971999</json:string><json:string>AIHW National Perinatal Statistics, 2004</json:string><json:string>AIHW National Perinatal Statistics Unit, 2006</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/NVC-BW4Q1Q7H-6</json:string></ark><categories><wos></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - general & internal medicine</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - General Medicine</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1136/bmj.c1279</json:string></doi><id>558732F739111153CE6A4712E22405B18CA0047C</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-BW4Q1Q7H-6/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-BW4Q1Q7H-6/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/NVC-BW4Q1Q7H-6/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a">Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">British Medical Journal Publishing Group</publisher><availability status="free"><p>Open Access</p></availability><date>2010-03-18</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study</title><author role="org"><orgName>The ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System</orgName><affiliation>Correspondence to: I Seppelt, Department of Intensive Care Medicine, Nepean Hospital, PO Box 63, Penrith, NSW 2751, Sydney, Australia seppelt@med.usyd.edu.au</affiliation></author><idno type="istex">558732F739111153CE6A4712E22405B18CA0047C</idno><idno type="ark">ark:/67375/NVC-BW4Q1Q7H-6</idno><idno type="DOI">10.1136/bmj.c1279</idno><idno type="href">bmj-340-bmj-c1279.pdf</idno><idno type="article-id">sepi742908</idno><idno type="PMID">20299694</idno><idno type="local">bmj;340/mar18_3/c1279</idno></analytic><monogr><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="pISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><idno type="publisher-id">bmj</idno><idno type="PublisherID-hwp">bmj</idno><idno type="PublisherID-nlm-ta">BMJ</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2010"></date><biblScope unit="volume">340</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010-03-18</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>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.</p></abstract><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Infectious diseases</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Epidemiologic studies</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Pregnancy</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Reproductive medicine</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Child health</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Neonatal and paediatric intensive care</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Neonatal health</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-03-18">Created</change><change when="2010">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-BW4Q1Q7H-6/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article 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pub-id-type="other">bmj.c1279</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Infectious diseases</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Epidemiologic studies</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Pregnancy</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Reproductive medicine</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Child health</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Neonatal and paediatric intensive care</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Neonatal health</subject></subj-group></article-categories><title-group><article-title>Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study</article-title></title-group><contrib-group><contrib><collab>The ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System</collab></contrib></contrib-group><author-notes><corresp>Correspondence to: I Seppelt, Department of Intensive Care Medicine, Nepean Hospital, PO Box 63, Penrith, NSW 2751, Sydney, Australia <email>seppelt@med.usyd.edu.au</email></corresp></author-notes><pub-date pub-type="collection"><year>2010</year></pub-date><pub-date pub-type="ppub"><year>2010</year></pub-date><pub-date pub-type="epub-original"><year>2010</year></pub-date><pub-date pub-type="epub"><day>18</day><month>3</month><year>2010</year></pub-date><volume>340</volume><volume-id pub-id-type="other">340</volume-id><volume-id pub-id-type="other">340</volume-id><elocation-id>c1279</elocation-id><history><date date-type="accepted"><day>22</day><month>February</month><year>2010</year></date></history><permissions><copyright-statement>© The ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System 2010</copyright-statement><copyright-year>2010</copyright-year><copyright-holder>The ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System</copyright-holder><license license-type="open-access"><p>This 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: <ext-link xlink:href="http://creativecommons.org/licenses/by-nc/2.0/" ext-link-type="uri">http://creativecommons.org/licenses/by-nc/2.0/</ext-link> and <ext-link xlink:href="http://creativecommons.org/licenses/by-nc/2.0/legalcode" ext-link-type="uri">http://creativecommons.org/licenses/by-nc/2.0/legalcode</ext-link>.</p></license></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="bmj-340-bmj-c1279.pdf"></self-uri><abstract><p><bold>Objective</bold> To describe the epidemiology of 2009 A/H1N1 influenza in critically ill pregnant women.</p><p><bold>Design</bold> Population based cohort study.</p><p><bold>Setting</bold> All intensive care units in Australia and New Zealand.</p><p><bold>Participants</bold> 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.</p><p><bold>Main outcome measures</bold> Maternal and neonatal mortality and morbidity.</p><p><bold>Results</bold> 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.</p><p><bold>Conclusions</bold> Pregnancy is a risk factor for critical illness related to 2009 H1N1 influenza, which causes maternal and neonatal morbidity and mortality.</p></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study</title></titleInfo><name type="corporate"><namePart>The ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System</namePart><affiliation>Correspondence to: I Seppelt, Department of Intensive Care Medicine, Nepean Hospital, PO Box 63, Penrith, NSW 2751, Sydney, Australia seppelt@med.usyd.edu.au</affiliation></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>British Medical Journal Publishing Group</publisher><dateIssued encoding="w3cdtf">2010</dateIssued><dateCreated encoding="w3cdtf">2010-03-18</dateCreated><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>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.</abstract><relatedItem type="host"><titleInfo><title>BMJ</title></titleInfo><titleInfo type="abbreviated"><title>BMJ</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>hwp-journal-coll</genre><topic>Infectious diseases</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Epidemiologic studies</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Pregnancy</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Reproductive medicine</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Child health</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Neonatal and paediatric intensive care</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Neonatal health</topic></subject><identifier type="ISSN">0959-8138</identifier><identifier type="eISSN">1468-5833</identifier><identifier type="PublisherID">bmj</identifier><identifier type="PublisherID-hwp">bmj</identifier><identifier type="PublisherID-nlm-ta">BMJ</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>340</number></detail></part></relatedItem><identifier type="istex">558732F739111153CE6A4712E22405B18CA0047C</identifier><identifier type="ark">ark:/67375/NVC-BW4Q1Q7H-6</identifier><identifier type="DOI">10.1136/bmj.c1279</identifier><identifier type="href">bmj-340-bmj-c1279.pdf</identifier><identifier type="ArticleID">sepi742908</identifier><identifier type="PMID">20299694</identifier><identifier type="local">bmj;340/mar18_3/c1279</identifier><accessCondition type="use and reproduction" contentType="open-access">This 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.</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</recordContentSource><recordOrigin>© The ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System 2010</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-BW4Q1Q7H-6/record.json</uri></json:item></metadata><annexes><json:item><extension>jpeg</extension><original>true</original><mimetype>image/jpeg</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-BW4Q1Q7H-6/annexes.jpeg</uri></json:item></annexes><author></author><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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