Health Protection Research Group, Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham, United Kingdom.
PLoS One. 2012;7(8):e41638. doi: 10.1371/journal.pone.0041638. Epub 2012 Aug 3.
The Influenza Clinical Information Network (FLU-CIN) was established to gather detailed clinical and epidemiological information about patients with laboratory confirmed A(H1N1)pdm09 infection in UK hospitals. This report focuses on the clinical course and outcomes of infection in pregnancy.
A standardised data extraction form was used to obtain detailed clinical information from hospital case notes and electronic records, for patients with PCR-confirmed A(H1N1)pdm09 infection admitted to 13 sentinel hospitals in five clinical 'hubs' and a further 62 non-sentinel hospitals, between 11th May 2009 and 31st January 2010.Outcomes were compared for pregnant and non-pregnant women aged 15-44 years, using univariate and multivariable techniques.
Of the 395 women aged 15-44 years, 82 (21%) were pregnant; 73 (89%) in the second or third trimester. Pregnant women were significantly less likely to exhibit severe respiratory distress at initial assessment (OR = 0.49 (95% CI: 0.30-0.82)), require supplemental oxygen on admission (OR = 0.40 (95% CI: 0.20-0.80)), or have underlying co-morbidities (p-trend <0.001). However, they were equally likely to be admitted to high dependency (Level 2) or intensive care (Level 3) and/or to die, after adjustment for potential confounders (adj. OR = 0.93 (95% CI: 0.46-1.92). Of 11 pregnant women needing Level 2/3 care, 10 required mechanical ventilation and three died.
Since the expected prevalence of pregnancy in the source population was 6%, our data suggest that pregnancy greatly increased the likelihood of hospital admission with A(H1N1)pdm09. Pregnant women were less likely than non-pregnant women to have respiratory distress on admission, but severe outcomes were equally likely in both groups.
流感临床信息网络（FLU-CIN）成立的目的是收集英国医院实验室确诊的 A(H1N1)pdm09 感染患者的详细临床和流行病学信息。本报告重点介绍妊娠期间感染的临床过程和结局。
使用标准化数据提取表从医院病历和电子记录中获取 13 家监测医院和另外 62 家非监测医院的 11 名患者的详细临床信息5 个临床“中心”于 2009 年 5 月 11 日至 2010 年 1 月 31 日期间接受 PCR 确诊的 A(H1N1)pdm09 感染。使用单变量和多变量技术比较了妊娠和非妊娠年龄在 15-44 岁的妇女的结果。
在 395 名年龄在 15-44 岁的妇女中，有 82 名（21%）怀孕；其中 73 名（89%）处于第二或第三孕期。在初始评估时，孕妇出现严重呼吸窘迫的可能性明显较低（OR=0.49（95%CI：0.30-0.82）），需要入院时补充氧气（OR=0.40（95%CI：0.20-0.80）），或存在潜在合并症（p 趋势<0.001）。然而，在调整了潜在混杂因素后，她们同样有可能被收入高度依赖（2 级）或重症监护（3 级）和/或死亡（调整后 OR=0.93（95%CI：0.46-1.92））。在需要 2/3 级护理的 11 名孕妇中，有 10 名需要机械通气，有 3 名死亡。
由于源人群中预期的妊娠发生率为 6%，我们的数据表明，妊娠大大增加了 A(H1N1)pdm09 感染住院的可能性。与非妊娠妇女相比，孕妇入院时呼吸窘迫的可能性较低，但两组的严重结局发生率相当。
