Pandemic Influenza (H1N1 2009) among Pregnant Korean Women

Baek-Nam Kim; Yee Gyung Kwak; Chi-Sook Moon; Yeon-Sook Kim; Eu Suk Kim; Kkot Sil Lee; Chang-Seop Lee; Ji-An Hur

doi:10.3947/ic.2011.43.1.55

Journal List > Infect Chemother > v.43(1) > 1035128

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Kwak, Moon, Kim, Kim, Lee, Lee, and Hur: Pandemic Influenza (H1N1 2009) among Pregnant Korean Women

Original Article

Infection & Chemotherapy

Infection & Chemotherapy 2011; 43(1): 55-59.

Published online: 28 February 2011

DOI: https://doi.org/10.3947/ic.2011.43.1.55

Pandemic Influenza (H1N1 2009) among Pregnant Korean Women

Baek-Nam Kim¹

, Yee Gyung Kwak¹, Chi-Sook Moon¹, Yeon-Sook Kim², Eu Suk Kim³, Kkot Sil Lee⁴, Chang-Seop Lee⁵, Ji-An Hur⁶

¹Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.

²Division of Infectious Diseases, Chungnam National University Hospital, Daejon, Korea.

³Division of Infectious Diseases, Dongguk University Ilsan Hospital, Goyang, Korea.

⁴Division of Infectious Diseases, Kwandong University Myongji Hospital, Goyang, Korea.

⁵Department of Internal Medicine, Chonbuk National University Medical School and the Research Institute of Clinical Medicine, Jeonju, Korea.

⁶Division of Infectious Diseases, Yeungnam University Hospital, Daegu, Korea.

Correspondence to Eu Suk Kim, M.D. Department of Internal Medicine, Dongguk University Ilsan Hospital, 814, Siksa-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-773, Republic of Korea. Tel: +82-31-961-7140, Fax: +82-31-961-8331, yonathan@hanafos.com

Received 15 October 2010 Revised 7 December 2010 Accepted 30 December 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Pregnant women are at an increased risk for severe illness and complications associated with pandemic (H1N1) 2009. This study was conducted to identify the severity of pandemic (H1N1) 2009 in pregnant Korean women.

Materials and Methods

The demographic and clinical data from pregnant women with laboratory confirmed pandemic (H1N1) 2009 during September to December 2009 were retrospectively collected from 8 hospitals in Korea.

Results

A total of 150 pregnant women with pandemic (H1N1) 2009 were identified. The median age was 30 years (range: 22-39 years), and the median gestational age (n=114) was 20 weeks (range: 1-39 weeks). All but one patient with secondary bacterial pneumonia had influenza without complication. Although 12 pregnant women needed hospitalization, there were no patients who needed admission to the intensive care unit or who died. Only one hospitalized patient had elective cesarean section because of oligohydamnios. No maternal or fetal complications directly related to the pandemic (H1N1) 2009 were identified among the 67 pregnant women who were followed up for 1 to 185 days after their influenza illness, including 6 women who delivered during the study period.

Conclusions

In contrast with the reports from Western countries, pandemic (H1N1) 2009 among pregnant Korean women was mild.

Keywords: Influenza, Influenza A(H1N1), Pandemic, Pregnancy

Figures and Tables

Figure 1

(A) Monthly number of women of child bearing age who visited the flu clinic and (B) the number of pregnant women who had confirmed pandemic (H1N1) 2009 in 8 Korean hospitals from September to December 2009.

Table 1

Characteristics of the Pregnant Women who were Infected with Pandemic (H1N1) from October to September 2009

^aThe gestational age was not identified for 36 pregnant women.

^bPreterm rupture of membranes and fetal distress one and two months after the diagnosis of pandemic influenza (H1N1) 2009, respectively.

References

1. Dodds L, McNeil SA, Fell DB, Allen VM, Coombs A, Scott J, MacDonald N. Impact of influenza exposure on rates of hospital admissions and physician visits because of respiratory illness among pregnant women. CMAJ. 2007. 176:463–468.

2. Neuzil KM, Reed GW, Mitchel EF, Simonsen L, Griffin MR. Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. Am J Epidemiol. 1998. 148:1094–1102.

3. Freeman DW, Barno A. Deaths from Asian influenza associated with pregnancy. Am J Obstet Gynecol. 1959. 78:1172–1175.

4. Harris JW. Influenza occurring in pregnant women: a statistical study of thirteen hundred and fifty cases. JAMA. 1919. 72:978–980.

5. Cono J, Cragan JD, Jamieson DJ, Rasmussen SA. Prophylaxis and treatment of pregnant women for emerging infections and bioterrorism emergencies. Emerg Infect Dis. 2006. 12:1631–1637.

6. Jamieson DJ, Theiler RN, Rasmussen SA. Emerging infections and pregnancy. Emerg Infect Dis. 2006. 12:1638–1643.

7. Rasmussen SA, Jamieson DJ, Bresee JS. Pandemic influenza and pregnant women. Emerg Infect Dis. 2008. 14:95–100.

8. Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS, Lindstrom S, Louie JK, Christ CM, Bohm SR, Fonseca VP, Ritger KA, Kuhles DJ, Eggers P, Bruce H, Davidson HA, Lutterloh E, Harris ML, Burke C, Cocoros N, Finelli L, MacFarlane KF, Shu B, Olsen SJ. Novel Influenza A (H1N1) Pregnancy Working Group. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009. 374:451–458.

9. Brown CM. Severe influenza A virus (H1N1) infection in pregnancy. Obstet Gynecol. 2010. 115:412–414.

10. Hewagama S, Walker SP, Stuart RL, Gordon C, Johnson PD, Friedman ND, O'Reilly M, Cheng AC, Giles ML. 2009 H1N1 influenza A and pregnancy outcomes in Victoria, Australia. Clin Infect Dis. 2010. 50:686–690.

11. Louie JK, Acosta M, Jamieson DJ, Honein MA. California Pandemic (H1N1) Working Group. Severe 2009 H1N1 influenza in pregnant and postpartum women in California. N Engl J Med. 2010. 362:27–35.

12. Miller AC, Safi F, Hussain S, Subramanian RA, Elamin EM, Sinert R. Novel influenza A(H1N1) virus among gravid admissions. Arch Intern Med. 2010. 170:868–873.

13. Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, Louie J, Doyle TJ, Crockett M, Lynfield R, Moore Z, Wiedeman C, Anand M, Tabony L, Nielsen CF, Waller K, Page S, Thompson JM, Avery C, Springs CB, Jones T, Williams JL, Newsome K, Finelli L, Jamieson DJ. Pandemic H1N1 Influenza in Pregnancy Working Group. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. JAMA. 2010. 303:1517–1525.

14. ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System. Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study. BMJ. 2010. 340:c1279.

15. ANZIC Influenza Investigators. Webb SA, Pettilä V, Seppelt I, Bellomo R, Bailey M, Cooper DJ, Cretikos M, Davies AR, Finfer S, Harrigan PW, Hart GK, Howe B, Iredell JR, McArthur C, Mitchell I, Morrison S, Nichol AD, Paterson DL, Peake S, Richards B, Stephens D, Turner A, Yung M. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med. 2009. 361:1925–1934.

16. Centers for Disease Control and Prevention (CDC). 2009 pandemic influenza A (H1N1) in pregnant women requiring intensive care - New York city, 2009. MMWR Morb Mortal Wkly Rep. 2010. 59:321–326.

17. Campbell A, Rodin R, Kropp R, Mao Y, Hong Z, Vachon J, Spika J, Pelletier L. Risk of severe outcomes among patients admitted to hospital with pandemic (H1N1) influenza. CMAJ. 2010. 182:349–355.

18. Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, Stelfox T, Bagshaw S, Choong K, Lamontagne F, Turgeon AF, Lapinsky S, Ahern SP, Smith O, Siddiqui F, Jouvet P, Khwaja K, McIntyre L, Menon K, Hutchison J, Hornstein D, Joffe A, Lauzier F, Singh J, Karachi T, Wiebe K, Olafson K, Ramsey C, Sharma S, Dodek P, Meade M, Hall R, Fowler RA. Canadian Critical Care Trials Group H1N1 Collaborative. Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA. 2009. 302:1872–1879.

19. Oluyomi-Obi T, Avery L, Schneider C, Kumar A, Lapinsky S, Menticoglou S, Zarychanski R. Perinatal and maternal outcomes in critically ill obstetrics patients with pandemic H1N1 Influenza A. J Obstet Gynaecol Can. 2010. 32:443–447. 448–452.

20. Lim ML, Chong CY, Tee WS, Lim WY, Chee JJ. Influenza A/H1N1 (2009) infection in pregnancy--an Asian perspective. BJOG. 2010. 117:551–556.

21. Gérardin P, El Amrani R, Cyrille B, Gabrieèle M, Guillermin P, Boukerrou M, Boumahni B, Randrianaivo H, Winer A, Rouanet JF, Bohrer M, Jaffar-Bandjee MC, Robillard PY, Barau G, Michault A. Low clinical burden of 2009 pandemic influenza A (H1N1) infection during pregnancy on the island of La Réunion. PLoS One. 2010. 5:e10896.

22. Kim BN, Kwak YG, Moon CS, Kim YS, Kim ES, Bae IG, Yeom JS, Lee CS, Hur JA. Trend in age distribution of visitors to flu-clinics during the pandemic influenza (H1N1 2009). Infect Chemother. 2010. 42:90–94.

23. Creanga AA, Johnson TF, Graitcer SB, Hartman LK, Al-Samarrai T, Schwarz AG, Chu SY, Sackoff JE, Jamieson DJ, Fine AD, Shapiro-Mendoza CK, Jones LE, Uyeki TM, Balter S, Bish CL, Finelli L, Honein MA. Severity of 2009 pandemic influenza A (H1N1) virus infection in pregnant women. Obstet Gynecol. 2010. 115:717–726.

24. Korea Centers for Disease Control and Prevention. Epidemiologic characteristics of influenza A(H1N1)2009 confirmed cases in Korea. Public Health Wkly Rep. 2009. 2:656–657.

25. Lee H, Kang YA, Kim HS, Shin SY, Kim JH, Kim JS, Hong SB. Epidemiological characteristics based on the underlying diseases for the deaths related to pandemic H1N1 influenza in Korea. Korean J Crit Care Med. 2010. 25:83–88.

26. Honarvar B, Asadi N, Ghaffarpasand F, Moghadami M, Kasraeian M. Pregnancy outcomes among patients infected with pandemic H1N1 influenza virus in Shiraz, Iran. Int J Gynaecol Obstet. 2010. 111:86–87.

27. Langenegger E, Coetzee A, Jacobs S, le Roux A, Theron G. Severe acute respiratory infection with influenza A (H1N1) during pregnancy. S Afr Med J. 2009. 99:713–714. 716

28. Lim ML, Chong CY, Tee WS, Lim WY, Chee JJ. Influenza A/H1N1 (2009) infection in pregnancy--an Asian perspective. BJOG. 2010. 117:551–556.

29. Yamada T, Yamada T, Saito T, Sengoku K, Minakami H. No maternal mortality from pandemic (H1N1) 2009 occurred in Japan. Accessed 30 Semptember 2010. Available at: http://www.bmj.com/content/340/bmj.c1279.abstract/reply#bmj_el_239927.

30. Yang P, Deng Y, Pang X, Shi W, Li X, Tian L, Zhang Y, Wang X, Huang F, Raina MC, Wang Q. Severe, critical and fatal cases of 2009 H1N1 influenza in China. J Infect. 2010. 61:277–283.

31. Lapinsky SE. Critical illness as a result of influenza A/H1N1 infection in pregnancy. BMJ. 2010. 340:c1235.

32. Korea Centers for Disease Control and Prevention. Influenza A (H1N1) 2009 vaccination program in Korea. Public Health Wkly Rep. 2009. 2:761.

33. Lee DH, Shin SS, Jun BY, Lee JK. National level response to pandemic (H1N1) 2009. J Prev Med Public Health. 2010. 43:99–104.

34. Korea Centers for Disease Control and Prevention. Serologic cross-reactivity of serum samples from different age groups in Korea against a novel influenza A (H1N1) virus. Public Health Wkly Rep. 2009. 2:744–745.

35. Centers for Disease Control and Prevention. Serum cross-reactive antibody response to a novel influenza A (H1N1) virus after vaccination with seasonal influenza vaccine. MMWR Morb Mortal Wkly Rep. 2009. 58:521–524.

TOOLS

ORCID iDs: Baek-Nam Kim
https://orcid.org/http://orcid.org/0000-0001-5551-2132
Similar articles