A comparative study to assess the epidemiological profile & outcome among pregnant and non-pregnant women infected with Influenza A H1N1 attending a tertiary care hospital of southern Rajasthan region of India

Introduction: Pregnant females are at higher risk for development of respiratory complications women mainly because of their altered immunity and physiological adaptations. Compared to non-pregnant individuals, pregnant women are more likely to develop influenza-associated complications, severe disease, and death. This study is carried out to analyze the epidemiological factors associated with outcome in pregnant women who suffered from H1N1 infection as well as to compare the outcome of HINI infection in pregnant and non-pregnant women. Materials and Methods: Descriptive and hospital based study of all Swine flu positive pregnant and non-pregnant females reported to OPD & admitted in Isolation and ICU from Jan to Dec 2015 were included in the study. The demographic data was collected for each patient and the following details were noted and analyzed: gestational age at diagnosis, duration of hospitalization, place of admission, mechanical ventilation status and maternal neonatal outcome. Results: The study revealed that during study period total 2344 women attended swine flu OPD, out of them 686 women tested by RT-PCR. In 282 cases, RT PCR was H1N1 positive. Out of them 147 women were admitted in isolation ward and ICU for further investigation and treatment. Out of 147 admitted confirmed cases, 30 females were pregnant, 67 were admitted in ICU. Total 33 swine positive females were expired, out of them 28 were put on ventilator and 7 were pregnant. Most of the females belong to rural background. Healthcare seeking behaviour was higher in Pregnant female with significantly higher duration of stay in hospital. More pregnant women (69.23%) put on ventilator than non-pregnant (38.89%). Case fatality rate in pregnant females (23.33%) was higher in compare to non-pregnant population (22.22%). Conclusions: Pregnancy is associated with high CFR, longer duration of hospitalization, more need of ICU admission as well as mechanical ventilation. ICU. It may be due to low awareness and late presentation especially in the women belonged to rural areas.