Swine Flu Striking Pregnant Women Hard: CDC Study

by Julie Steenhuysen
From Reuters Health Information

CHICAGO (Reuters) Jul 29 - Pregnant women infected with the new H1N1 swine flu have a much higher risk of severe illness and death, U.S. government researchers said on Wednesday, confirming a trend that has worried global health experts.
While pregnant women have always had a higher risk of severe disease from influenza in general, the new H1N1 virus is taking an exceptionally heavy toll, the researchers said.
"We do see a fourfold increase in hospitalization rates among ill pregnant women compared to the general population," Dr. Denise Jamieson of the U.S. Centers for Disease Control and Prevention said in a telephone interview.
"We're also seeing a relatively large proportion of deaths among pregnant women. We report 13% in the paper, but that is a very unstable number based on a small number of deaths reported," said Jamieson, whose study appears in The Lancet medical journal.
The study was based on the deaths of six pregnant women out of 45 deaths related to H1N1 reported to the CDC between April 15 and June 16.
All of the women were healthy prior to infection, and all developed pneumonia and needed to be put on a ventilator.
Dr. Jamieson said 302 deaths have been officially reported to the CDC from the new H1N1 virus.
"Among those, we have relatively complete information on 266 deaths. And of those, 15 have been among pregnant women, which is about 6%," Dr. Jamieson said.
Given that at any point, about 1% of the U.S. population is pregnant, she said, pregnant women "are definitely over-represented in terms of the proportion of deaths."
However, Dr. Jamieson said: "There is no reason to delay pregnancy or to be overly concerned. We do not have evidence that pregnant women have increased susceptibility or are more likely to acquire influenza."
"It's just that when they have influenza they are at increased risk of having severe disease," she said.
Dr. Keiji Fukuda of the World Health Organization said WHO has not yet decided on its policy on the use of antivirals for pregnant women with H1N1.
"Given the overall situation in many countries where the supplies of antivirals can be limited at times, to concentrate them on treating people who are sick makes a lot of sense," he said on Britain's Sky television.
Dr. Fukuda said researchers are debating whether it is best to use antivirals to prevent disease or to treat sick people.
Dr. Jamieson said physicians need to provide a separate waiting area for pregnant women who suspect they are ill, to protect healthy pregnant women from infection.
She also said pregnant women with influenza should be given antiviral drugs as soon as possible, within the first 48 hours to be most effective.
Despite recommendations from the Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists that all pregnant women get a seasonal flu shot, less than 14% do, according to the CDC.
The ACIP, which advises the CDC, is meeting later on Wednesday to decide who should be first to get the new H1N1 vaccine.
The full article is available at: http://press.thelancet.com/h1n1pregart.pdf