RESUMO
We describe the efforts of the Maternal Health Team, which was formed to address the needs of pregnant and breastfeeding women during the Centers for Disease Control and Prevention's (CDC's) 2009 pandemic influenza A (2009 H1N1) emergency response. We examined the team's activities, constructed a timeline of key pandemic events, and analyzed the Maternal Health 2009 H1N1 inquiry database. During the pandemic response, 9 guidance documents that addressed the needs of pregnant and breastfeeding women and their providers were developed by the Maternal Health Team. The Team received 4661 maternal health-related inquiries that came primarily from the public (75.5%) and were vaccine related (69.3%). Peak inquiry volume coincided with peak hospitalizations (October-November 2009). The Maternal Health 2009 H1N1 inquiry database proved useful to identify information needs of the public and health care providers during the pandemic.
Assuntos
Centers for Disease Control and Prevention, U.S./organização & administração , Informação de Saúde ao Consumidor/estatística & dados numéricos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/prevenção & controle , Bem-Estar Materno , Pandemias/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Aleitamento Materno , Bases de Dados Factuais , Feminino , Necessidades e Demandas de Serviços de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Vacinas contra Influenza , Influenza Humana/epidemiologia , Guias de Prática Clínica como Assunto , Gravidez , Estados Unidos/epidemiologiaRESUMO
To summarize the literature regarding 2009 H1N1 influenza A during pregnancy, we conducted a systematic literature review using a PubMed search and other strategies. Studies were included if they reported 2009 H1N1 influenza in pregnant women as original data. In all, 2153 abstracts were reviewed, and a total of 120 studies were included. Data were extracted regarding number of cases, additional risk factors for influenza-associated complications, treatment, and maternal and pregnancy outcomes. Authors were contacted to determine the extent of overlap when it was suspected. Pregnancy was associated with increased risk of hospital and intensive care unit admission and of death. Pregnant women who received delayed treatment with neuraminidase inhibitors or who had additional risk factors were more likely to develop severe disease. Preterm and emergency cesarean deliveries were frequently reported. These results reinforce the importance of early identification and treatment of suspected influenza in this high-risk population.
