| Title |
Severe maternal morbidity due to respiratory disease and impact of 2009 H1N1 influenza A pandemic in Brazil: results from a national multicenter cross-sectional study
|
|---|---|
| Published in |
BMC Infectious Diseases, May 2016
|
| DOI | 10.1186/s12879-016-1525-z |
| Pubmed ID | |
| Authors |
L. C. Pfitscher, J. G. Cecatti, R. C. Pacagnella, S. M. Haddad, M. A. Parpinelli, J. P. Souza, S. M. Quintana, F. G. Surita, M. H. Sousa, M. L. Costa, Brazilian Network for Surveillance of Severe Maternal Morbidity Group |
| Abstract |
The aim of this study was to assess the burden of respiratory disease, considering the influenza A pandemic season (H1N1pdm09), within the Brazilian Network for Surveillance of Severe Maternal Morbidity, and factors associated with worse maternal outcome. A multicenter cross-sectional study, involving 27 referral maternity hospitals in five Brazilian regions. Cases were identified in a prospective surveillance by using the WHO standardized criteria for potentially life-threatening conditions (PLTC) and maternal near miss (MNM). Women with severe complications from respiratory disease identified as suspected or confirmed cases of H1N1 influenza or respiratory failure were compared to those with other causes of severe morbidity. A review of suspected H1N1 influenza cases classified women as non-tested, tested positive and tested negative, comparing their outcomes. Factors associated with severe maternal outcome (SMO = MNM + MD) were assessed in both groups, in comparison to PLTC, using PR and 95 % CI adjusted for design effect of cluster sampling. Among 9555 cases of severe maternal morbidity, 485 (5 %) had respiratory disease. Respiratory disease occurred in one-quarter of MNM cases and two-thirds of MD. H1N1 virus was suspected in 206 cases with respiratory illness. Around 60 % of these women were tested, yielding 49 confirmed cases. Confirmed H1N1 influenza cases had worse adverse outcomes (MNM:MD ratio < 1 (0.9:1), compared to 12:1 in cases due to other causes), and a mortality index > 50 %, in comparison to 7.4 % in other causes of severe maternal morbidity. Delay in medical care was associated with SMO in all cases considered, with a two-fold increased risk among respiratory disease patients. Perinatal outcome was worse in cases complicated by respiratory disease, with increased prematurity, stillbirth, low birth weight and Apgar score < 7. Respiratory disease, especially considering the influenza season, is a very severe cause of maternal near miss and death. Increased awareness about this condition, preventive vaccination during pregnancy, early diagnosis and treatment are required to improve maternal health. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Venezuela, Bolivarian Republic of | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 115 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 115 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 14 | 12% |
| Student > Postgraduate | 13 | 11% |
| Student > Master | 13 | 11% |
| Researcher | 11 | 10% |
| Professor > Associate Professor | 8 | 7% |
| Other | 27 | 23% |
| Unknown | 29 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 42 | 37% |
| Nursing and Health Professions | 12 | 10% |
| Social Sciences | 6 | 5% |
| Immunology and Microbiology | 3 | 3% |
| Agricultural and Biological Sciences | 3 | 3% |
| Other | 16 | 14% |
| Unknown | 33 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 May 2016.
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#18,459,684
of 22,873,031 outputs
Outputs from BMC Infectious Diseases
#5,615
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#249,956
of 333,164 outputs
Outputs of similar age from BMC Infectious Diseases
#114
of 155 outputs
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