Grant: Operating Grant: Health Systems Research on H1N1

This project is to learn more about risk factors for H1N1 flu in pregnancy and the safety of antiviral medication and H1N1 vaccination in pregnancy. We want to learn more about: 1) risk factors for HIN1 infection in pregnant women and predictors of who gets the flu vaccine, 2) if antiviral medication use during pregnancy is associated with any better or worse pregnancy and birth outcomes, and, 3) if H1N1 vaccination during pregnancy is associated with any better or worse pregnancy and birth outcomes. Pregnancy seems to be associated with increased risk of serious complications from flu in mothers and newborns. Vaccination is recommended for pregnant women at all stages of pregnancy, even though the safety of influenza H1N1 vaccine has not been fully tested in this group. For pregnant women with suspected H1N1 infection, antiviral medications are recommended despite not knowing a lot about the use of these medications during pregnancy. This study will help us understand more about the use of antiviral medication and influenza vaccines among pregnant women and their babies. We will use a database of births in Ontario (Niday Perinatal Database) to look at all women who delivered a baby more than 500 grams or at 20 weeks' or more of pregnancy between November 1, 2009 and October 31, 2010. This database collects information on every birth in the province and recently added questions on whether a woman had the flu, took medication or had a flu vaccination during her pregnancy. We will look at the flu information as well as other information about the mother, her pregnancy, the labour and birth and the baby. If poor pregnancy or birth outcomes are noted, they will be compared between pregnant women with and without H1N1 flu, with and without H1N1 flu vaccination, and with and without use of antiviral medication.