H1N1 Flu Fatal for 28 Pregnant Women

By Diane Loupe

WeNews correspondent

Thursday, January 7, 2010

Health authorities urge H1N1 flu vaccinations for pregnant women, who make up 1 percent of the population but 6 percent of H1N1 deaths. Some women balk, but plenty roll up their sleeves. Flu season lasts until May.

ATLANTA (WOMENSENEWS)--When obstetrician Stuart Pancer advises his pregnant patients to get the H1N1 shot, he's unusually persuasive.

"I tell my patients that I've seen a woman die from this and I haven't seen very many women die," said Pancer, who has been a specialist in reproductive health care for 14 years and practices in suburban Atlanta.

At least 28 pregnant women with H1N1, commonly known as swine flu, died last year in the United States and another 100 were admitted to an intensive care unit through Aug. 21, according to the latest Centers for Disease Control and Prevention, or CDC, figures. Pregnant women are 7.7 times more likely to die from H1N1 compared with the general population, according to an August 2009 editorial in the medical journal Lancet.

However, pregnant women who get the H1N1 vaccine get sick less often and their babies are less likely to get sick with the flu than babies whose mothers did not get a flu shot, the CDC says.

This fall, Pancer was called to DeKalb Medical Center to tend to a Kentucky woman. Twenty-four weeks pregnant, she had arrived at the emergency room in this suburban Atlanta hospital with fever and shortness of breath. She quickly deteriorated, went into intensive care and began receiving intensive, specialized care.

Pancer performed an emergency Caesarian section on the woman in the intensive care unit, delivering a 26-week-old baby. A few days later, the mother was disconnected from life support. Her baby is doing well and living with its grandmother.

"We were all in a state of shock," said Pancer, whose patient was one of at least two pregnant women who died this fall at DeKalb Medical Center from complications of H1N1 influenza. News of the deaths spurred inoculations for H1N1.

When Pancer's office was able to get supplies of the H1N1 vaccine, he began urging all of his patients to get it, free of charge.

Some Women Refused Shot

But some women refused, either saying they've never been sick with the flu or they just don't like shots.

"It's amazing to me that a little bit of scary information can overwhelm all of the good," said Pancer. "I tell them, 'I saw her die.' And they still say, 'Well, you know, I'll be careful.' It's very irrational."

Doctors have always been cautious about giving any medication to pregnant women because of the risk to the still-forming fetus. But a spike in deaths and hospitalizations of pregnant women with H1N1 changed that.

"We have an increasing number of obstetricians who are vaccinating their patients or at least knowing where their patients can be vaccinated," Thomas Frieden, director of the CDC, said in a recent news conference.

The CDC doesn't know precisely how many pregnant women have already been inoculated against H1N1, but doctors and other health officials say they think women are rolling up their sleeves at a high rate.

It's not too late to get the shot since flu season lasts until May.

Until recently, almost all of the flu cases health officials had seen were H1N1, but seasonal flu--protected by a seasonal flu shot--is emerging, the CDC's Frieden said in December.

Pregnant women should get the H1N1 or seasonal flu shot, not the nasal spray version of the vaccine, which is made with live, weakened flu virus and is not approved for pregnant women, the CDC says.

However, after women have given birth, the nasal spray vaccine is safe for women, even if they are nursing.

Federal health officials and the medical community are pushing the vaccine, stressing evidence that shows it's a far safer alternative than catching the flu.

"The seasonal flu vaccine has been used for many years in millions of pregnant women and we have not seen any increased adverse events for mothers and babies," said Naomi K. Tepper, an obstetrician-gynecologist and medical officer of the CDC's Division of Reproductive Health.