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The Comparative Clinical Course of Pregnant and Non-Pregnant Women Hospitalised with Influenza A(H1N1)pdm09 Infection

INTRODUCTION: 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 preg...

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Autores principales: Dolan, Gayle P., Myles, Puja R., Brett, Stephen J., Enstone, Joanne E., Read, Robert C., Openshaw, Peter J. M., Semple, Malcolm G., Lim, Wei Shen, Taylor, Bruce L., McMenamin, James, Nicholson, Karl G., Bannister, Barbara, Nguyen-Van-Tam, Jonathan S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411676/
https://www.ncbi.nlm.nih.gov/pubmed/22870239
http://dx.doi.org/10.1371/journal.pone.0041638
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author Dolan, Gayle P.
Myles, Puja R.
Brett, Stephen J.
Enstone, Joanne E.
Read, Robert C.
Openshaw, Peter J. M.
Semple, Malcolm G.
Lim, Wei Shen
Taylor, Bruce L.
McMenamin, James
Nicholson, Karl G.
Bannister, Barbara
Nguyen-Van-Tam, Jonathan S.
author_facet Dolan, Gayle P.
Myles, Puja R.
Brett, Stephen J.
Enstone, Joanne E.
Read, Robert C.
Openshaw, Peter J. M.
Semple, Malcolm G.
Lim, Wei Shen
Taylor, Bruce L.
McMenamin, James
Nicholson, Karl G.
Bannister, Barbara
Nguyen-Van-Tam, Jonathan S.
author_sort Dolan, Gayle P.
collection PubMed
description INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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spelling pubmed-34116762012-08-06 The Comparative Clinical Course of Pregnant and Non-Pregnant Women Hospitalised with Influenza A(H1N1)pdm09 Infection Dolan, Gayle P. Myles, Puja R. Brett, Stephen J. Enstone, Joanne E. Read, Robert C. Openshaw, Peter J. M. Semple, Malcolm G. Lim, Wei Shen Taylor, Bruce L. McMenamin, James Nicholson, Karl G. Bannister, Barbara Nguyen-Van-Tam, Jonathan S. PLoS One Research Article INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Public Library of Science 2012-08-03 /pmc/articles/PMC3411676/ /pubmed/22870239 http://dx.doi.org/10.1371/journal.pone.0041638 Text en © 2012 Dolan et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Dolan, Gayle P.
Myles, Puja R.
Brett, Stephen J.
Enstone, Joanne E.
Read, Robert C.
Openshaw, Peter J. M.
Semple, Malcolm G.
Lim, Wei Shen
Taylor, Bruce L.
McMenamin, James
Nicholson, Karl G.
Bannister, Barbara
Nguyen-Van-Tam, Jonathan S.
The Comparative Clinical Course of Pregnant and Non-Pregnant Women Hospitalised with Influenza A(H1N1)pdm09 Infection
title The Comparative Clinical Course of Pregnant and Non-Pregnant Women Hospitalised with Influenza A(H1N1)pdm09 Infection
title_full The Comparative Clinical Course of Pregnant and Non-Pregnant Women Hospitalised with Influenza A(H1N1)pdm09 Infection
title_fullStr The Comparative Clinical Course of Pregnant and Non-Pregnant Women Hospitalised with Influenza A(H1N1)pdm09 Infection
title_full_unstemmed The Comparative Clinical Course of Pregnant and Non-Pregnant Women Hospitalised with Influenza A(H1N1)pdm09 Infection
title_short The Comparative Clinical Course of Pregnant and Non-Pregnant Women Hospitalised with Influenza A(H1N1)pdm09 Infection
title_sort comparative clinical course of pregnant and non-pregnant women hospitalised with influenza a(h1n1)pdm09 infection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411676/
https://www.ncbi.nlm.nih.gov/pubmed/22870239
http://dx.doi.org/10.1371/journal.pone.0041638
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