Dataset Information

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

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.

SUBMITTER: Li F

PROVIDER: S-EPMC3400061 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

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

Li Furong F Chen Guoping G Wang Jianjun J Liu Hong H Wu Jiabing J

BMJ open 20120707 4

<h4>Objectives</h4>To describe the risk factors associated with death in pregnant women with severe pandemic H1N1 infection.<h4>Design</h4>Case-control study.<h4>Setting</h4>Anhui, China.<h4>Participants</h4>A total of 46 pregnant women with severe pandemic H1N1 infection were studied during June 2009-April 2011.<h4>Primary and secondary outcome measures</h4>All the cases were confirmed by the clinicians and epidemiologists together based on the positive laboratory result.<h4>Results</h4>Of the ...[more]

PMID: 22773536

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Project description:BackgroundMaternal HIV increases the risk of adverse birth outcomes including preterm birth, fetal growth restriction, and stillbirth, but the biological mechanism(s) underlying this increased risk are not well understood. We hypothesized that maternal HIV may lead to adverse birth outcomes through an imbalance in angiogenic factors involved in the vascular endothelial growth factor (VEGF) signaling pathway.MethodsIn a case-control study nested within an ongoing cohort in Zambia, our primary outcomes were serum concentrations of VEGF-A, soluble endoglin (sEng), placental growth factor (PlGF), and soluble fms-like tyrosine kinase-1 (sFLT-1). These were measured in 57 women with HIV (cases) and 57 women without HIV (controls) before 16 gestational weeks. We used the Wilcoxon rank-sum and linear regression controlling for maternal body mass index (BMI) and parity to assess the difference in biomarker concentrations between cases and controls. We also used logistic regression to test for associations between biomarker concentration and adverse pregnancy outcomes (preeclampsia, preterm birth, small for gestational age, stillbirth, and a composite of preterm birth or stillbirth).ResultsCompared to controls, women with HIV had significantly lower median concentrations of PlGF (7.6 vs 10.2 pg/mL, p = 0.02) and sFLT-1 (1647.9 vs 2055.6 pg/mL, p = 0.04), but these findings were not confirmed in adjusted analysis. PlGF concentration was lower among women who delivered preterm compared to those who delivered at term (6.7 vs 9.6 pg/mL, p = 0.03) and among those who experienced the composite adverse birth outcome (6.2 vs 9.8 pg/mL, p = 0.02). Median sFLT-1 concentration was lower among participants with the composite outcome (1621.0 vs 1945.9 pg/mL, p = 0.04), but the association was not significant in adjusted analysis. sEng was not associated with either adverse birth outcomes or HIV. VEGF-A was undetectable by Luminex in all specimens.ConclusionsWe present preliminary findings that HIV is associated with a shift in the VEGF signaling pathway in early pregnancy, although adjusted analyses were inconclusive. We confirm an association between angiogenic biomarkers and adverse birth outcomes in our population. Larger studies are needed to further elucidate the role of HIV on placental angiogenesis and adverse birth outcomes.

Dataset Information

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

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

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

Similar Datasets

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