The encouraging news is that 78 percent of the hospitals that responded have formal written plans in place to address communications, a surge in patient volume and possible degradation of non-essential medical services. All facilities planned to provide care to their own employees despite the potential for significant shortages of both personnel and supplies, and 56 percent of the hospitals planned to provide augmented day-care services for employees' children to help workers continue to work.

An additional area of concern is coordination with local, state and federal government public health agencies. Many hospitals, particularly private ones, are uncertain how they would interact with public health agencies.

Still, public health agencies will play a critical role in providing information, medications and vaccine dissemination since they will be supplied by the federal strategic stockpile and may have the most accurate information as a pandemic unfolds, Dr. Beigi reported.

Although it is difficult to predict when the next influenza pandemic will occur, large scale outbreaks have been reported every 10 to 40 years. The emergence of H5N1 avian influenza in 1997 and the fact that nearly 40 years have passed since the last outbreak makes the threat of a severe pandemic a realistic possibility in the near future.

"Many challenges remain if we are to improve on our efforts to optimize outcomes for pregnant women and newborns during the next influenza pandemic," he said. "It is hoped that this study will stimulate planning efforts for all hospitals providing maternity care in preparation for this apparently inevitable infectious disease outbreak."

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