Doctors treating pregnant women suffering from swine flu frequently find it difficult to control their complications.
According to a study published last month in the International Journal of Health and Allied Sciences authored by Mumbai-based Dr Shilpa Shah along with six other doctors from USA and Brazil, increased levels of immunoglobulin, anti-estrogen antibodies and anti-progesterone antibodies is responsible for making pregnant women more vulnerable to complications of H1N1 virus.
The study was conducted on 26 women aged between 18 and 51 years in 2009-10 in Rio-de-Janeiro, Brazil. Three groups were formed — non-pregnant women, pregnant healthy women and pregnant women with swine flu.
The study found that pregnant women had higher levels of immunoglobulin G (IgG) and IgM anti-estrogen-antibodies as compared to non-pregnant women. In pregnant women with swine flu, there were further elevated levels of IgG and IgA anti-estrogen-antibodies and anti-progesterone. Interestingly, the levels of IgE, a class of immunoglobulin, dipped in pregnant women infected with swine flu.
Estrogen and progesterone both affect the immune responses of the body, which explains why swine flu severity is higher among pregnant women than other women.
“This work suggests that though swine flu is an infection, it results in an auto-immune endocrine condition, especially in females. This information may help treating physicians think in a new direction to help patients,” said Shah.
While no pregnant woman has yet contracted the disease in the city this year, experts with the civic health department admitted that a handful of cases of pregnant women with swine flu were noted in the past with serious complications.
Dr Om Srivastava, who treats infectious diseases, said, “Pregnant women are in high risk groups and immune reaction is different in their body. They need to be monitored closely.” He added that pregnant women with swine flu are susceptible to pulmonary failure, cardiac arrest, heart problems and adult respiratory distress syndrome.
BMC’s deputy executive health officer Dr Mangala Gomare said that apart from pregnant women, senior citizens, pediatric cases, HIV and tuberculosis patients, and patients suffering from diabetes and hypertension also come under the umbrella of high risk groups for the H1N1 virus. “These are people with lower immunity and severity increases if they contract the air-borne swine flu infection.”
On Wednesday, 22 new cases of swine flu were recorded by the civic health department in the city, of which 16 patients are residents of Mumbai and six are from outside Mumbai. Data showed that the incidence of swine flu is currently higher in the western suburbs. Ten of the 16 patients who tested positive for the virus were from areas including Goregaon, Kandivali, Andheri, Mumbai Central and Bandra.
Until now, six deaths (all out-station residents) have been reported this year.