The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66501

Melissa A. Schiff, MD, MPH, Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Ave, Box 359960, Seattle, WA 98104, 206-521-1527, mschiff@u.washington.edu, Victoria L. Holt, PhD, MPH, Dept. of Epidemiology, University of Washington, Box 358080 (MP 474), Seattle, WA 98195-8080, and Janet R. Daling, PhD, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fariview Ave. N., MP-381, Seattle, WA 98195-8080.

Purpose: This study evaluated maternal and perinatal outcomes following hospitalization for a motor vehicle crash (MVC) during pregnancy. Methods: A retrospective cohort design was used to evaluate women hospitalized for an MVC during pregnancy in Washington State from 1989 – 1997. Pregnant women hospitalized for a crash were identified by linking Washington State birth and fetal death certificate data with hospital discharge data and compared to a randomly chosen group of delivering women not experiencing an injury hospitalization during pregnancy. The Injury Severity Score (ISS) was used to classify pregnant women’s injuries into non-severely injured (ISS 1-8) and severely injured (ISS>9). Poisson regression analysis was used to estimate age-adjusted relative risks (RR) and 95% confidence intervals (95% CI) for associations between injury severity and pregnancy outcomes. Results: Among the 275 pregnant women hospitalized for MVC injuries with a valid ISS, 216 had non-severe, and 59 had severe injuries. Non-severely injured women were at increased risk of preterm labor (RR 3.6, 95% CI 2.8-4.8), placental abruption (RR 5.0, 95% CI 2.9-8.6), and fetal death (RR 6.0, 95% CI 2.4-15.2) and severely injured women were at increased risk of preterm labor (RR 2.1, 95% CI 1.1-4.1), delivery at <37 weeks (RR 2.2, 95% CI 1.2-4.3), placental abruption (RR 10.6, 95% CI 5.2-21.6), cesarean delivery (RR 1.8, 95% CI 1.1-2.8), fetal distress (RR 2.0, 95% CI 1.1-3.4), and fetal death (RR 8.6, 95% CI 2.1-35.8) compared to uninjured women. Conclusion: Close monitoring of pregnant crash victims is advised even for those with minor injuries.

Learning Objectives:

• 1. Describe risk factors for a motor vehicle crash during pregnancy.
• 2. List adverse pregnancy outcomes associated with non-severe and severe injuries following a crash during pregnancy
• 3. Recognize the importance of monitoring the pregnant woman and her fetus following a motor vehicle crash, regardless of injury severity.

Keywords: Maternal Morbidity, Motor Vehicles

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.