Chonnam Med J.  2013 Aug;49(2):96-99. 10.4068/cmj.2013.49.2.96.

Was 2009 Pandemic Influenza A (H1N1) Mild Among Pregnant Korean Women?

• An JH
• Kim HN
• Choi OJ
• Kim GS
• Kim UJ
• Jang MO
• Kang SJ
• Park KH
• Jung SI
• Kwon YS
• Jang HC

• KMID: 1428272
• DOI: http://doi.org/10.4068/cmj.2013.49.2.96

Abstract

Clinical and laboratory data from Western countries suggest that pregnant women are at an increased risk for severe illness and complications associated with 2009 pandemic influenza A (H1N1). However, previous data among Korean women suggested a less severe outcome. In this study performed at a single referral center in Korea, rates of admission, pneumonia, intensive care unit admission, and death related to 2009 pandemic influenza A (H1N1) were significantly higher in 33 pregnant women than in 723 nonpregnant women of reproductive age (p<0.05 each). We report two cases of 2009 pandemic influenza A (H1N1) in pregnant Korean women who were admitted to the intensive care unit because of severe pneumonia that led to maternal and fetal death in one of the patients. This case series suggests that pregnant Korean women were also at increased risk of severe illness and complications during the 2009 pandemic influenza A (H1N1) outbreak.

Keyword

Pandemics; Influenza; H1N1; Pregnancy

MeSH Terms

Female
Fetal Death
Humans
Influenza, Human
Intensive Care Units
Korea
Pandemics
Pneumonia
Pregnancy
Pregnant Women
Referral and Consultation

Figure

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  FIG. 1 Results of the chest radiography and the computed tomography performed on the day of admission in Case 1. Multifocal pulmonary infiltration in both lobes and pleural effusion were observed on chest radiography and computed tomography.

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  FIG. 2 Results of the chest radiography and the computed tomography performed on the day of admission in Case 2. Multifocal peribronchial and subpleural consolidations and ground glass opacities with air-bronchogram in both lungs were observed on chest radiography and computed tomography.

Reference

1. Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS, et al. Novel Influenza A (H1N1) Pregnancy Working Group. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009; 374:451–458.

2. 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.

3. Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, et al. 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.

4. 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.

5. Hewagama S, Walker SP, Stuart RL, Gordon C, Johnson PD, Friedman ND, et al. 2009 H1N1 influenza A and pregnancy outcomes in Victoria, Australia. Clin Infect Dis. 2010; 50:686–690.

6. Kim BN, Kwak YG, Moon CS, Kim YS, Kim ES, Lee KS, et al. Pandemic influenza (H1N1 2009) among pregnant Korean women. Infect Chemother. 2011; 43:55–59.

7. Hong SD, Park SH, Kang SJ, Kwon YS, Kee SJ, Park KH, et al. First fatal oseltamivir-resistant 2009 pandemic influenza A (H1N1) case in an adult in Korea. Chonnam Med J. 2011; 47:127–129.

8. Forbes RL, Wark PA, Murphy VE, Gibson PG. Pregnant women have attenuated innate interferon responses to 2009 pandemic influenza A virus subtype H1N1. J Infect Dis. 2012; 206:646–653.

9. Tsatsanis C, Margioris AN, Kontoyiannis DP. Association between H1N1 infection severity and obesity-adiponectin as a potential etiologic factor. J Infect Dis. 2010; 202:459–460.

10. Hur JA. A fatal case in pregnant woman infected by H1N1 2009 in Korea. Infect Chemother. 2011; 43:225–228.