Pregnant women have a risk four times greater complications after infection with influenza A H1N1. These data encourage health authorities to act quickly to detect and handle this viral infection during pregnancy.
Published in late July in the prestigious medical journal The Lancet , a U.S. study has highlighted the increased risk of severe or fatal damage during pregnancy following infection with influenza A H1N1. Data that make the alarming support for pregnant women.
Influenza A: Pregnant women have 4 times greater risk of complications
Researchers at the control and prevention of disease (Centers for Disease Control and Prevention) have analyzed the cases of 34 pregnant women infected with the pandemic virus. They found that nearly one third of them (32% or 11 women) had been hospitalized. According to their study, pregnant women infected with influenza A H1/N1 have a prior 4 times greater risk of complications. In these women, the risk of death from pneumonia and respiratory distress is also higher than average.
According to the World Health Organization (WHO), several other countries, where there is a transmission range of the pandemic virus, have also reported an increased risk for pregnant women, especially in the second and third trimester of pregnancy . They also reported an increased risk of fetal death and spontaneous abortions.
For pregnant women, initiate treatment without delay
If you still do not know if pregnant women are more likely to contract the virus, what we know now is that once sick, they incur greater risk of complications.
On the one hand, these findings are not all surprising. First, data from past pandemics supports the fact that pregnant women are exposed to greater risk. On the other hand, risk takes on added significance with the current pandemic, which continues to affect the age groups younger than that seen with seasonal flu.
Thus in regions where infection by the H1N1 virus is widespread, the World Health recommends "very pregnant women and their doctors to carefully monitor the possible occurrence of any influenza-like symptoms. But the treatments available are compatible with pregnancy? Yes, as a publication of the Journal of the Association of Canadian physicians (Canadian Medical Association Journal).
Canadian researchers believe that new antivirals (the neuraminidase inhibitors - Tamiflu ® and Relenza ®) can be used in pregnant women and nursing mothers, focusing however oseltamivir (Tamiflu ®) for which more data on safety are available. The conclusions set by the WHO considers it "necessary to administer antiretroviral treatment with oseltamivir as soon as possible after symptoms appear. This treatment with maximum efficiency within 48 hours, the doctors must prescribing immediately and not wait for the results of laboratory tests. Even beyond this period, the WHO states that "limitation later may also be beneficial (...) for lowering the risk of pneumonia (one of the causes of death most frequently reported in individuals infected) and needs hospitalization.
Pregnant women a priority for vaccine
Nobody knows yet unclear what factors that expose pregnant women to more complications. According to Dr. Denis Jamieson, lead author of the study in The Lancet 1, the mechanical and hormonal changes, particularly in the cardiovascular system, respiratory and immune systems may partly explain this phenomenon. Possibilities include a reduction of lung capacity due to the greater role of the uterus compresses the diaphragm. These changes expose pregnant women to greater risk of contracting influenza virus.
The impact of illness on the child is so far unclear. Five babies died 6 women were born by caesarean section and are in good health. At the time of publication of this study, only one baby delivered by Caesarean section 13 weeks prematurely, was still in hospital.
In view of these data, WHO recommends that health authorities to classify pregnant women in the priority groups for vaccination when vaccines against pandemic influenza will be available. Several other risk categories were identified: those suffering from a pathological condition underlying, especially chronic pulmonary (including asthma patients), cardiovascular disease, diabetes, immunosuppression and extreme obesity.
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