BMJ. 2010 Mar 18;340:c1279. doi: 10.1136/bmj.c1279.
To describe the epidemiology of 2009 A/H1N1 influenza in critically ill pregnant women.
Population based cohort study.
All intensive care units in Australia and New Zealand.
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.
Maternal and neonatal mortality and morbidity.
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.
Pregnancy is a risk factor for critical illness related to 2009 H1N1 influenza, which causes maternal and neonatal morbidity and mortality.
描述重症 2009 年甲型 H1N1 流感孕妇的流行病学特征。
基于人群的队列研究。
澳大利亚和新西兰所有的重症监护病房。
所有在 2009 年 6 月 1 日至 8 月 31 日期间，因感染甲型 H1N1 流感而在澳大利亚或新西兰的重症监护病房住院的孕妇或产后不久的妇女。
产妇和新生儿发病率和死亡率。
64 名因感染甲型 H1N1 流感而住进重症监护病房的孕妇或产后不久的妇女中，有 64 名确诊为 2009 年甲型 H1N1 流感。与育龄非孕妇相比，感染 2009 年甲型 H1N1 流感的孕妇或产后妇女住进重症监护病房的风险增加（相对危险度 7.4，95%置信区间 5.5 至 10.0）。妊娠 20 周或以上的孕妇风险增加 13 倍（13.2，9.6 至 18.3）。住进重症监护病房时，22 名妇女（34%）处于产后阶段，2 名妇女流产。14 名妇女（22%）在重症监护期间分娩，26 名妇女（41%）出院时仍处于妊娠状态。所有产妇随后都分娩了。44 名妇女（69%）接受了机械通气。其中 9 名妇女（14%）接受了体外膜肺氧合治疗。7 名妇女（11%）死亡。在 20 周以上的 60 次分娩中，有 4 次是死产，3 次是婴儿死亡。22 名（39%）活产婴儿为早产儿，32 名（57%）被收入新生儿重症监护病房。20 名婴儿中有 2 名检测出 2009 年甲型 H1N1 病毒阳性。
妊娠是感染 2009 年甲型 H1N1 流感相关重症的危险因素，可导致产妇和新生儿发病率和死亡率增加。
