A case-control study on risk factors associated with death in pregnant women with severe pandemic H1N1 infection

BMJ Open. 2012 Jul 7;2(4):e000827. doi: 10.1136/bmjopen-2012-000827. Print 2012.

Abstract

Objectives: To describe the risk factors associated with death in pregnant women with severe pandemic H1N1 infection.

Design: Case-control study.

Setting: Anhui, China.

Participants: A total of 46 pregnant women with severe pandemic H1N1 infection were studied during June 2009-April 2011.

Primary and secondary outcome measures: All the cases were confirmed by the clinicians and epidemiologists together based on the positive laboratory result.

Results: Of the seven pregnant women who died of the pandemic H1N1 infection, five (70%) cases were in their third trimester. Twenty-nine (63%) cases from the surviving group were admitted to hospital within 3 days after the onset of symptoms, while only one (2%) case from the death group took the earliest admission 2 days after the onset. There was a significant difference on how soon to be admitted between the death and the surviving groups (OR 0.09, 95% CI 0.01 to 0.68). The median time of administrating corticosteroids was 5 days after the onset in the death group and 3 days in the surviving group showing no significant difference between them (p=0.056).

Conclusions: For the pregnant women with severe p(H1N1) infection, the risk factors associated with death were as follows: the delay of antiviral treatment and being in the third trimester. The corticosteroids therapy appeared to have no effects on preventing the cases from death.