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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 R.; Peaceman, Alan M.; Louis, Judette M.; & Wapner, Ronald J., et al. (2011). Influenza-Like Illness in Hospitalized Pregnant and Postpartum Women during the 2009-2010 H1N1 Pandemic. Obstetrics & Gynecology, 118(3), 593-600. PMCID: PMC3160605


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.


Reference Type

Journal Article

Year Published


Journal Title

Obstetrics & Gynecology


Varner, Michael W.
Rice, Madeline Murguia
Anderson, Brenna
Tolosa, Jorge E.
Sheffield, Jeanne
Spong, Catherine Y.
Saade, George R.
Peaceman, Alan M.
Louis, Judette M.
Wapner, Ronald J.
Tita, Alan T. N.
Sorokin, Yoram
Blackwell, Sean C.
Prasad, Mona
Thorp, John M., Jr.
Naresh, Amber
VanDorsten, J. Peter, for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network