THE OBSTETRIC AND PERINATAL OUTCOMES OF ACUTE RESPIRATORY INFECTION-COMPLICATED PREGNANCY IN THE SECOND TRIMESTER OF PREGNANCY

Objective. To evaluate the impact of acute respiratory infection (ARI) experienced in the second trimester of pregnancy during the 2009 A(H1N1) influenza pandemic on obstetric and perinatal outcomes. Material and methods. One hundred and thirty-five labor histories in the women who had experienced ARI in the second trimester (at 13-14-to-27-28 weeks gestation) during the 2009 A(H1N1) influenza pandemic and given birth to babies in the Territorial Perinatal Center, Chita, and their newborn infants’ histories were retrospectively analyzed. Results. The risk factors of ARI in the second trimester of pregnancy were smoking (37.7%), kidney diseases (36.2%), chronic herpesvirus and cytomegalovirus infection without exacerbations (34.8%), cardiovascular diseases (28.8%), chronic obstructive pulmonary diseases (7.4%), and alimentary-constitutional obesity (8.8%). The major pregnancy complication after prior ARI was subcompensated placental insufficiency (49.6%) that formed the basis for the development of complications, such as threatening miscarriage (14%), fetal hypoxia (49.6%), and gestosis (35.5%). The infants born to the women having a history of ARI were significantly more frequently to have impaired adaption in the early neonatal period (57%) with evolving grades I and II cerebral ischemia (46.6 and 13.3%), and neonatal hyperbilirubinemia (21.5%). Among the neonates, there were 7 (5.1%) babies with congenital malformations, of them there were 2 fatal cases (one had lobar holoprosencephalopathy, external and internal hydrocephalus; the other had multiple malformations of the cardiovascular, urinary, and osteoarticular systems) (1.48%) and 5 cases of other anomalies (ventricular septal defect (1.48%), polydactyly (1.48%), and vascular plexus cyst (0.74%). Conclusion. ARI experienced in the second trimester of pregnancy results in the complicated course of both pregnancy and early neonatality.

pregnancy, acute respiratory infection, A(H1N1) influenza, placental insufficiency