Jamieson Denise J, Honein Margaret A, Rasmussen Sonja A, Williams Jennifer L, Swerdlow David L, Biggerstaff Matthew S, Lindstrom Stephen, Louie Janice K, Christ Cara M, Bohm Susan R, Fonseca Vincent P, Ritger Kathleen A, Kuhles Daniel J, Eggers Paula, Bruce Hollianne, Davidson Heidi A, Lutterloh Emily, Harris Meghan L, Burke Colleen, Cocoros Noelle, Finelli Lyn, MacFarlane Kitty F, Shu Bo, Olsen Sonja J
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA.
Lancet. 2009 Aug 8;374(9688):451-8. doi: 10.1016/S0140-6736(09)61304-0. Epub 2009 Jul 28.
Pandemic H1N1 2009 influenza virus has been identified as the cause of a widespread outbreak of febrile respiratory infection in the USA and worldwide. We summarised cases of infection with pandemic H1N1 virus in pregnant women identified in the USA during the first month of the present outbreak, and deaths associated with this virus during the first 2 months of the outbreak.
After initial reports of infection in pregnant women, the US Centers for Disease Control and Prevention (CDC) began systematically collecting additional information about cases and deaths in pregnant women in the USA with pandemic H1N1 virus infection as part of enhanced surveillance. A confirmed case was defined as an acute respiratory illness with laboratory-confirmed pandemic H1N1 virus infection by real-time reverse-transcriptase PCR or viral culture; a probable case was defined as a person with an acute febrile respiratory illness who was positive for influenza A, but negative for H1 and H3. We used population estimates derived from the 2007 census data to calculate rates of admission to hospital and illness.
From April 15 to May 18, 2009, 34 confirmed or probable cases of pandemic H1N1 in pregnant women were reported to CDC from 13 states. 11 (32%) women were admitted to hospital. The estimated rate of admission for pandemic H1N1 influenza virus infection in pregnant women during the first month of the outbreak was higher than it was in the general population (0.32 per 100 000 pregnant women, 95% CI 0.13-0.52 vs 0.076 per 100 000 population at risk, 95% CI 0.07-0.09). Between April 15 and June 16, 2009, six deaths in pregnant women were reported to the CDC; all were in women who had developed pneumonia and subsequent acute respiratory distress syndrome requiring mechanical ventilation.
Pregnant women might be at increased risk for complications from pandemic H1N1 virus infection. These data lend support to the present recommendation to promptly treat pregnant women with H1N1 influenza virus infection with anti-influenza drugs.
US CDC.
2009年甲型H1N1流感大流行病毒已被确认为美国及全球范围内发热性呼吸道感染广泛爆发的病因。我们总结了此次疫情爆发首月在美国确诊的孕妇感染甲型H1N1大流行病毒的病例，以及疫情爆发头两个月内与此病毒相关的死亡病例。
在首次报告孕妇感染病例后，美国疾病控制与预防中心（CDC）开始系统收集美国感染甲型H1N1大流行病毒的孕妇病例及死亡病例的更多信息，作为强化监测的一部分。确诊病例定义为通过实时逆转录聚合酶链反应或病毒培养确诊感染甲型H1N1大流行病毒的急性呼吸道疾病；疑似病例定义为甲型流感检测呈阳性，但H1和H3检测呈阴性的急性发热性呼吸道疾病患者。我们使用从2007年人口普查数据得出的人口估计数来计算住院率和发病率。
2009年4月15日至5月18日，13个州向CDC报告了34例确诊或疑似孕妇感染甲型H1N1病例。11名（32%）妇女住院治疗。疫情爆发首月孕妇感染甲型H1N1流感大流行病毒的估计住院率高于普通人群（每10万名孕妇中有0.32例，95%可信区间0.13 - 0.52，而每10万名有感染风险的人群中有0.076例，95%可信区间0.07 - 0.09）。2009年4月15日至6月16日，向CDC报告了6例孕妇死亡病例；所有死亡孕妇均患有肺炎，并随后发展为需要机械通气的急性呼吸窘迫综合征。
孕妇感染甲型H1N1大流行病毒后出现并发症的风险可能更高。这些数据支持了目前关于及时使用抗流感药物治疗感染甲型H1N1流感病毒的孕妇的建议。
美国疾病控制与预防中心。
