Long-term fetal outcomes in pregnant trauma patients.
BACKGROUND
Trauma during pregnancy is associated with significant maternal and fetal morbidity and mortality, typically occurring during the hospital admission. Less is known about the delayed effects of trauma on pregnancy outcome once the patient has been discharged from the hospital with a viable fetus.


METHODS
A retrospective cohort study was conducted of pregnant trauma patients who were discharged from the trauma center with a viable fetus. Risk of preterm delivery (PTD) and low birth weight (LBW) were compared between injured patients (Injury Severity Score > 0) and those without identified injury (Injury Severity Score = 0), for the remainder of pregnancy.


RESULTS
Even after trauma center discharge, injured patients had a nearly 2-fold higher risk of PTD (relative risk, 1.9; 95% confidence interval, 1.1-3.3) and LBW (relative risk, 1.8; 95% confidence interval, 1.04-3.2) for the remainder of the pregnancy. The risk was higher with increasing injury severity and among those injured early in gestation.


CONCLUSIONS
The risk of PTD and LBW in pregnant trauma patients who were discharged from trauma centers with a viable fetus remains increased throughout the remainder of the pregnancy. A history of trauma during gestation is a risk factor for poor pregnancy outcome.
Sperry
Jason L
JL
Department of Surgery, Division of Burns, Trauma and Surgical Critical Care, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Mail Stop 9158, Dallas, TX 75390-9158, USA.
Casey
Brian M
BM
McIntire
Donald D
DD
Minei
Joseph P
JP
Gentilello
Larry M
LM
Shafi
Shahid
S
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D015601:Injury Severity Score; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology*; D012189:Retrospective Studies; D012306:Risk; D013781:Texas; D013997:Time Factors; D014193:Trauma Centers; D014505:Urban Population; D014947:Wounds and Injuries / Q000150:complications*