PMID- 24216158
OWN - NLM
STAT- MEDLINE
DCOM- 20140728
LR  - 20131202
IS  - 1619-3997 (Electronic)
IS  - 0300-5577 (Linking)
VI  - 42
IP  - 1
DP  - 2014 Jan
TI  - Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia.
PG  - 19-26
LID - 10.1515/jpm-2013-0140 [doi]
AB  - AIMS: The 2009 H1N1 pandemic illustrated the higher morbidity and mortality from 
      viral infections in peripartum women. We describe clinical features of women who 
      recently died of H1N1 in Colombia. METHODS: This is a case series study that was 
      gathered through a retrospective record review of all maternal H1N1 deaths in the 
      country. The national mortality database of confirmed mortality from H1N1 in 
      pregnancy and up to 42 days after delivery was reviewed during the H1N1 season in 
      2009. Women with H1N1 infections were confirmed by the laboratory of virology. 
      Demographic, clinical, and laboratory data were reviewed. Statistical analyses 
      were performed and median values of non-parametric data were reported with 
      inter-quartile range (IQR). RESULTS: A total of 23 H1N1 maternal deaths were 
      identified. Eighty-three percent occurred in the third trimester. None of the 
      mothers who died had received influenza vaccination. The median time from symptom 
      onset to the initiation of antiviral treatment was 8.8 days (IQR 5.8-9.8). Five 
      fatalities did not receive any anti-viral therapy. Median PaO2/FiO2 on day 1 was 
      80 (IQR, 60-98.5). All patients required inotropic support and mechanical 
      ventilation with barotrauma-related complications of mechanical ventilation 
      occurring in 35% of patients. CONCLUSION: In Colombia, none of the women 
      suffering H1N1-related maternal deaths had received vaccination against the 
      disease and most had delayed or had no anti-viral therapy. Given the lack of 
      evidence-based clinical predictors to identify women who are prone to die from 
      H1N1 in pregnancy, following international guidelines for vaccination and 
      initiation of antiviral therapy in suspected cases would likely improve outcomes 
      in developing countries.
FAU - Rojas-Suarez, Jose
AU  - Rojas-Suarez J
FAU - Paternina-Caicedo, Angel
AU  - Paternina-Caicedo A
FAU - Cuevas, Liliana
AU  - Cuevas L
FAU - Angulo, Sofia
AU  - Angulo S
FAU - Cifuentes, Ricardo
AU  - Cifuentes R
FAU - Parra, Edgar
AU  - Parra E
FAU - Fino, Elena
AU  - Fino E
FAU - Daza, Jose
AU  - Daza J
FAU - Castillo, Orlando
AU  - Castillo O
FAU - Pacheco, Adriana
AU  - Pacheco A
FAU - Rey, Gloria
AU  - Rey G
FAU - Garcia, Sara
AU  - Garcia S
FAU - Pena, Isabel
AU  - Pena I
FAU - Levinson, Andrew
AU  - Levinson A
FAU - Bourjeily, Ghada
AU  - Bourjeily G
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - J Perinat Med
JT  - Journal of perinatal medicine
JID - 0361031
SB  - IM
CIN - J Perinat Med. 2014 Jan;42(1):27-9. PMID: 24142342
MH  - Adult
MH  - Colombia/epidemiology
MH  - Female
MH  - Humans
MH  - *Influenza A Virus, H1N1 Subtype
MH  - Influenza, Human/*mortality/pathology/therapy
MH  - Maternal Mortality
MH  - *Pandemics
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/*mortality/pathology/therapy
MH  - Retrospective Studies
EDAT- 2013/11/13 06:00
MHDA- 2014/07/30 06:00
CRDT- 2013/11/13 06:00
PHST- 2013/06/14 00:00 [received]
PHST- 2013/09/08 00:00 [accepted]
PHST- 2013/11/13 06:00 [entrez]
PHST- 2013/11/13 06:00 [pubmed]
PHST- 2014/07/30 06:00 [medline]
AID - /j/jpme.ahead-of-print/jpm-2013-0140/jpm-2013-0140.xml [pii]
AID - 10.1515/jpm-2013-0140 [doi]
PST - ppublish
SO  - J Perinat Med. 2014 Jan;42(1):19-26. doi: 10.1515/jpm-2013-0140.