2009～2010年北京市孕妇甲型H1N1流感流行病学特征

目的分析2009～2010年甲型H1N1流感大流行期间,孕妇甲型H1N1流感确诊病例流行病学特征。方法对北京市孕妇甲型H1N1流感确诊病例开展流行病学调查,描述病例发病时间、地区和职业分布,并利用Logistic回归探讨导致孕妇甲型H1N1流感病例死亡的相关因素。结果 2009～2010年北京市孕妇中累计出现确诊病例81例,危重症病例占30.9%,确诊病例病死率6.2%,死亡病例均为外来务工人员。孕妇危重症病例所占构成比和病例病死率高于育龄期女性(χ2=88.2,P<0.001;χ2=9.6,P<0.005)。多因素logistic回归分析显示,发病治疗时间间隔长、体重指数高是导致孕妇甲型H1N1流感病例死亡的危险因素。结论孕妇甲型H1N1流感确诊病例易并发呼吸衰竭和感染中毒性休克,且出现危重病例和死亡病例的危险性高于育龄期女性,外来务工人员是孕妇甲型H1N1流感防控的高危人群。

Epidemiological features of pandemic influenza A(H1N1)in pregnant women during 2009 to 2010

Objective To describe and analyze epidemiological features of confirmed cases of 2009 influenza A （H1N1） in pregnant women of Beijing during 2009 ～ 2010. Methods An epidemiological investigation was carried out for each case of diagnosis - confirmed case of 2009 influenza A （ H1N1） in pregnant women and women at child - bearing age. Their epidemiological features were described and analyzed,including temporal,geographical and occupational distribution of the cases. Logistic regression analysis was used to explore related factors for deaths in pregnant woman caused by influenza A （H1N1）. Results During 2009 ～ 2010,a total of 81 reported cases of 2009 influenza A （H1N1） occurred among pregnant women in Beijing,25 （30. 9% ） severe cases and six deaths who all were migrant laborers from other provinces and regions,with a case-fatality of 6. 2 percent. Proportion of severe cases and case - fatality of influenza A （H1N） in pregnant women were higher than those in child - bearing age women （ χ2 = 88. 2,P 0. 001 and χ2 = 9. 6,P 0. 005 ）. Results of multivariate logistic regression revealed that time interval between onset and initiating medication,and body mass index （BMI） were risk factors for death caused by influenza A （ H1N1） in pregnant women. Conclusion Diagnosis-confirmed influenza A （ H1N1） cases in pregnant women seems to be at risk to complicate with respiratory failure and infectious toxic shock,and they have higher risk to develop severe cases and lead to death than child-bearing age women do. Pregnant women in migrant laborers are key target population in its prevention and control.