JAMA logoNovel influenza A (H1N1) is a pandemic respiratory infection which apparently displays an increased threat to pregnant women. According to the study conducted by the State University of New York Downstate Medical Center and Kings County Hospital Center in Brooklyn pregnant women who contracted the H1N1 flu strain are at an increased risk for obstetrical complications. These complications may include fetal distress, premature delivery, emergency cesarean delivery and fetal death.

The authors highlighted that prior studies did reveal an elevated rate of hospitalization, increased illness and mortality amongst pregnant women suffering with seasonal influenza epidemics and pandemics. But they probably failed to report an increase in birth defects. It was ascertained that during the flu pandemics of 1918 and 1957, pregnant women had shown an increase in mortality rates.

“Novel influenza A (H1N1) is a pandemic respiratory infection commanding much attention by the international medical community. Little data have been reported regarding the impact of H1N1 on pregnant patients or the gestational fetus, and published reports have been conflicting,” explained Andrew C. Miller, M.D., of the State University of New York Downstate Medical Center and Kings County Hospital Center, Brooklyn, and colleagues.

To conduct the study investigators scrutinized data collected from 18 patients. All these patients were in an average age of 27 years and were hospitalized in two urban academic medical centers with a diagnosis of H1N1. They were admitted from May 18 to June 24, 2009. These results were then compared to the reports that were already made public, about the H1N1 outbreak and reports of flu pandemics of 1918 and 1957.

The authors further remarked, “Little data are available regarding fetal outcomes and mortality rates among H1N1-infected mothers. Of the 18 patients in this series, one had a spontaneous abortion and one died postnatally from complications of extreme prematurity and sepsis.”

In all the medical centers these patients were diagnosed with oseltamivir phosphate on the day of admission itself. From the total of 18 patients 3 were admitted to the intensive care unit. Seven patients delivered during their stay in the hospital stay itself, amongst which six were premature births. These six premature births included five that involved fetal distress and four that were delivered via emergency Cesarean delivery (C-section).

Although no congenital birth defects were discovered, two fetal deaths did occur while no maternal deaths were registered. The study enlightens the serious threat to pregnant women with H1N1. The authors further seem to recommend an early treatment and care for patients with this disease, especially pregnant women.

The study was published in the May 24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.