Risk factors associated with the increasing prevalence of pneumonia during pregnancy.

A retrospective chart review of 1120 antepartum admissions revealed the prevalence of antepartum pneumonia rose to 1 per 367 deliveries. A total of 26 cases in 9560 deliveries were identified with criteria of fever greater than 39 degrees C, productive cough, and radiologic findings of infiltrates or consolidation. Pregnancy-related outcome variables studied were prevalence of preterm labor or birth, birth weight, and trimester of occurrence. Pneumonia characteristics studied were rate and type of organisms recovered, seasonality, and severity of the illness and radiologic findings. Exposure variables relating to the development of pneumonia studied were underlying medical conditions, hematocrit, human immunodeficiency virus status, and drug use. Birth weight, hematocrit, human immunodeficiency virus status, and drug use were compared with a randomly selected sample of women drawn from the general population delivered of infants during the study time period. One patient experienced preterm delivery, which occurred 1 month after cure of pneumonia. Birth weight was significantly lower in the study group (2770 +/- 224 gm versus 3173 +/- 99 gm, p less than 0.01). The most common organism recovered was Streptococcus pneumoniae. A total of 42% of patients had multilobar involvement and two required intubation. Cocaine use (52% in the study group versus 10% in the general population, p less than 0.01) and human immunodeficiency virus positivity (24% in the study group versus 2% in the general population, p less than 0.01) were significant risk factors for antepartum pneumonia.