The impact of H1N1 influenza infection on pregnant women was astounding in its severity, according to several medical studies released this month. Pregnant women were categorized as one of the high-risk groups prioritized to receive vaccine in the fall.
This week, the CDC released a Morbidity and Mortality Weekly Report (MMWR) summarizing the results of monitoring and surveillance of pregnant women who were admitted to intensive care units in New York City. Many of the women did not receive oseltamivir treatment until five days after their initial symptoms emerged. Those who received the treatment within two days of symptom onset were more likely to recover. The study confirmed that pregnant women are at increased risk for severe illness and complications from infection with both seasonal and H1N1 influenza.
Another study, published in the British Medical Journal in March, also finds high rates of hospitalizations, severe illness, and death among pregnant women. Based on cases of H1N1 influenza in pregnant women admitted to hospitals in Australia and New Zealand, researchers found the risk of admission to intensive care for H1N1 was on average 13-fold greater for women at 20 or more weeks’ gestation (compared to non-pregnant women of childbearing age).
The American College of Obstetricians and Gynecologists (ACOG) has been communicating the risks of infection for pregnant women throughout the course of the H1N1 pandemic. In October, ACOG urged providers to vaccinate pregnant and postpartum women. At the time, pregnant women represented six percent of all confirmed H1N1 influenza deaths in the U.S. while only about 1 percent of the general population is pregnant. Typically, only 15 percent of pregnant women get the flu vaccine in any given year, compared to 30 percent of the general population.
This past January, the CDC released further guidance for providers who care for pregnant women, urging them to vaccinate pregnant patients during their prenatal visits and in scheduled vaccine clinics. For those who do not stock the vaccine, the CDC urges partnering with other health providers in order to increase access for pregnant patients.
From the CDC Web site
Options for referral include:
- Partnering with other offices in the geographic region and designating one site for vaccination
- Partnering with local hospitals or birthing centers where patients deliver
- Providing information to patients about local vaccination clinics