Maternal and infant outcomes after injury during pregnancy in Washington State from 1989 to 1997

Abstract

Background: Few population-based studies have assessed maternal and infant outcomes after nonfatal injuries occurring during pregnancy.

Methods: We performed a retrospective cohort study to assess outcomes of pregnant women hospitalized for injury in Washington State from 1989 to 1997. We used the Injury Severity Score (ISS) to classify 266 nonseverely injured (ISS of 1-8) and 28 severely injured (ISS > 9) pregnant women who delivered at their injury hospitalization. We compared these women to 12,578 pregnant women randomly selected from Washington State birth and fetal death certificates who had no injury hospitalization during pregnancy.

Results: Nonseverely injured pregnant women were at increased risk of placental abruption and their infants were at increased risk of hypoxia and fetal death. Severely injured pregnant women were at a 17-fold (95% confidence interval, 6.2-46.8) increased risk of placental abruption and their infants were at increased risk of prematurity, low birth weight, and fetal distress, and a 30-fold (95% confidence interval, 9.4-97.1) increased risk of fetal death.

Conclusion: Nonsevere as well as severe injuries resulting in hospitalization during pregnancy can result in adverse maternal and infant outcomes.