Citation

Ikossi DG, Lazar AA, Morabito D, Fildes JJ, Knudson MM. J. Am. Coll. Surg. 2005; 200(1): 49-56.

Affiliation

Department of Surgery, University of California, San Francisco, and the San Francisco Injury Center, San Francisco, CA.

Copyright

(Copyright © 2005, American College of Surgeons, Publisher Elsevier Publishing)

DOI

10.1016/j.jamcollsurg.2004.09.016

PMID

15631920

Abstract

BACKGROUND: Trauma is the number one cause of maternal death during pregnancy, but incidence of fetal loss exceeds maternal loss by more than 3 to 1. We hypothesized that we could identify women at risk for injury during pregnancy and focus our prevention efforts. STUDY DESIGN: Women of childbearing age in the American College of Surgeon's National Trauma Data Bank served as the study population. Pregnant patients were compared with nonpregnant patients with respect to age, race, mechanism of injury, injury patterns and severity, risk-taking behaviors, and outcomes. Multivariate logistic regression analysis was used to identify risk factors for loss of pregnancy in mothers who survived their trauma. RESULTS: Pregnant trauma patients (n = 1,195) were younger, less severely injured, and more likely to be African American or Hispanic as compared with the nonpregnant cohort (n = 76,126). Twenty percent of injured pregnant patients tested positive for drugs or alcohol, and approximately one-third of those involved in motor vehicle crashes were not using seatbelts. Independent risk factors for fetal loss after trauma included Injury Severity Score > 15; Adjusted Injury Score >/= 3 in the head, abdomen, thorax, or lower extremities; and Glasgow Coma Score