da Silva André Anjos, Ranieri Tani Maria Schilling, Torres Fernanda Duarte, Vianna Fernanda Sales Luiz, Paniz Graziella Rangel, Sanseverino Paula Baptista, Picon Paulo Dornelles, de Azevedo Pietro Baptista, Costa Marta Haas, Schuler-Faccini Lavinia, Sanseverino Maria Teresa Vieira
Teratogen Information Service, Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil ; Post-Graduate Program in Genetics and Molecular Biology at the Federal University of Rio Grande do Sul, Brazil.
Epidemiological Surveillance, Department of Health, Rio Grande do Sul, Brazil.
PLoS One. 2014 Feb 18;9(2):e88624. doi: 10.1371/journal.pone.0088624. eCollection 2014.
The emergence of a new subtype of the influenza virus in 2009 generated interest in the international medical community, the media, and the general population. Pregnant women are considered to be a group at risk of serious complications related to the H1N1 influenza virus. The aim of this study was to evaluate the outcomes and teratogenic effects of pregnancies exposed to the H1N1 virus during the Influenza A epidemic that occurred in the state of Rio Grande do Sul in 2009.
This is an uncontrolled prospective cohort study of pregnant women with suspected symptoms of Influenza A who were reported in the Information System for Notifiable Diseases-Influenza (SINAN-Influenza) during the epidemic of 2009 (database from the state of Rio Grande do Sul, Brazil). There were 589 cases of pregnant women with suspected infection. Among these, 243 were tested by PCR and included in the analysis. The main outcome measures were: maternal deaths, pregnancy outcome, stillbirths, premature births, low birth weight, congenital malformations, and odds ratios for H1N1+ and non-H1N1 pregnant women.
There were one hundred and sixty-three (67%) confirmed cases of H1N1, 34 cases (14%) of seasonal Influenza A and 46 (19%) who were negative for Influenza A. There was no difference between the three groups in clinical parameters of the disease. There were 24 maternal deaths--18 of them had H1N1. There were 8 stillbirths--5 were children of H1N1 infected mothers. There were no differences in perinatal outcomes.
The present data do not indicate an increase in teratogenic risk from exposure to the influenza A (H1N1) virus. These results will help to strengthen the data and clarify the health issues that arose after the pandemic.
2009年一种新型流感病毒亚型的出现引起了国际医学界、媒体和普通民众的关注。孕妇被认为是与H1N1流感病毒相关严重并发症的高危人群。本研究的目的是评估2009年南里奥格兰德州甲型流感流行期间感染H1N1病毒的孕妇的妊娠结局和致畸作用。
这是一项对2009年疫情期间在法定传染病信息系统-流感（SINAN-流感）中报告的疑似甲型流感症状孕妇进行的非对照前瞻性队列研究（来自巴西南里奥格兰德州的数据库）。有589例疑似感染的孕妇病例。其中，243例通过PCR检测并纳入分析。主要结局指标包括：孕产妇死亡、妊娠结局、死产、早产、低出生体重、先天性畸形以及H1N1阳性和非H1N1阳性孕妇的比值比。
确诊H1N1病例163例（67%），季节性甲型流感34例（14%），甲型流感阴性46例（19%）。三组疾病的临床参数无差异。有24例孕产妇死亡——其中18例感染H1N1。有8例死产——5例是感染H1N1母亲的孩子。围产期结局无差异。
目前的数据并未表明接触甲型流感（H1N1）病毒会增加致畸风险。这些结果将有助于加强数据并阐明大流行后出现的健康问题。
