A case–control study on risk factors associated with death in pregnant women with severe pandemic H1N1 infection

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Abstract
Objectives To describe the risk factors associated with death in pregnant women with severe pandemic H1N1 infection. Design Case–control study. Setting Anhui, China. Participants A total of 46 pregnant women with severe pandemic H1N1 infection were studied during June 2009–April 2011. Primary and secondary outcome measures All the cases were confirmed by the clinicians and epidemiologists together based on the positive laboratory result. Results Of the seven pregnant women who died of the pandemic H1N1 infection, five (70%) cases were in their third trimester. Twenty-nine (63%) cases from the surviving group were admitted to hospital within 3 days after the onset of symptoms, while only one (2%) case from the death group took the earliest admission 2 days after the onset. There was a significant difference on how soon to be admitted between the death and the surviving groups (OR 0.09, 95% CI 0.01 to 0.68). The median time of administrating corticosteroids was 5 days after the onset in the death group and 3 days in the surviving group showing no significant difference between them (p=0.056). Conclusions For the pregnant women with severe p(H1N1) infection, the risk factors associated with death were as follows: the delay of antiviral treatment and being in the third trimester. The corticosteroids therapy appeared to have no effects on preventing the cases from death.