Korean J Intern Med.  2019 Sep;34(5):1136-1144. 10.3904/kjim.2017.107.

Clinical and economic analysis of the 2009 H1N1 influenza pandemic among pregnant Korean women

Affiliations
  • 1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. heejinmd@korea.ac.kr
  • 2Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
  • 3Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
  • 4Department of Obstetrics and Gynecology, Inha University College of Medicine, Incheon, Korea.

Abstract

BACKGROUND/AIMS
Unlike Western countries, the 2009 pandemic influenza infection among pregnant women was reported as mild in a previous interim study in South Korea. However, several mortalities were reported thereafter, suggesting that nationwide data were lacking.
METHODS
This case-control study covers the entire 2009 pandemic inf luenza period, from May 2009 to February 2010. The clinical and economic data of pregnant (case) and age-matched non-pregnant (control) women with influenza A (H1N1) pdm09 virus (H1N1pdm09) infection were retrospectively collected from nine hospitals in South Korea.
RESULTS
A total of 130 pregnant women with H1N1pdm09 infection were identified. The mean age of the pregnant women was 31.1 years (range, 19 to 41) and mean gestational age was 18.4 weeks (range, 3 to 40). Both case and control groups were similar in terms of age (p = 0.43) and comorbidities (p = 0.18). The overall rate of complications was comparable between the two groups (p = 0.648). However, mortality was reported only among the cases, so mean economic per capita burden is estimated to be higher for pregnant women compared to the control (4,821,992 Korean won [KRW] vs. 351,233 KRW, p = 0.31). Obstetric complications were observed in 12 cases, including preterm labor (n = 7), low birth-weight (n = 3), miscarriage (n = 1), stillbirth (n = 1), and cleft lip (n = 1).
CONCLUSIONS
Although statistically insignificant, the detrimental impact of influenza A H1N1pdm09 on pregnancy can be serious in some complicated cases in South Korea. Thus, the strong recommendation of influenza vaccination should be maintained for pregnant women as a high priority.

Keyword

Pandemics; H1N1; Influenza, human; Pregnancy

MeSH Terms

Abortion, Spontaneous
Case-Control Studies
Cleft Lip
Comorbidity
Female
Gestational Age
Humans
Influenza, Human*
Korea
Mortality
Obstetric Labor, Premature
Pandemics*
Pregnancy
Pregnant Women
Retrospective Studies
Stillbirth
Vaccination
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