The epidemiology of pregnancy-associated emergency department injury visits and their impact on birth outcomes.
OBJECTIVE
Describe the demographics, injury types, mechanisms, and intents of emergency department (ED) injury visits by pregnant women and to quantify their risk of adverse birth outcomes.


METHODS
Through a retrospective cohort study design, Utah ED, birth, and fetal death records were probabilistically linked to identify women seen in an ED with an injury during pregnancy among births and fetal deaths from 1999 to 2002. Logistic regression was used to assess the effect of having an injury-related ED visit on various adverse pregnancy outcomes.


RESULTS
7350 (3.9%) women experienced an injury-related ED visit during pregnancy. Motor vehicle occupant injuries were the leading mechanism of ED injury visits (22.4%). Controlling for known risks, pregnant women with an injury-related ED visit were more likely than non-injured pregnant women to experience preterm labor (OR=1.22, 95% CI=1.12-1.34), placental abruption (OR=1.33, 95% CI=1.08-1.65), and cesarean delivery (OR=1.27, 95% CI=1.19-1.36). Infants born to women who were injured during pregnancy were more likely to be born preterm (OR=1.23, 95% CI=1.12-1.34) and have low birth weight (OR=1.22, 95% CI=1.1-1.35).


CONCLUSIONS
Most injured pregnant women are treated and released from the ED; however, significant increased risks remain for several maternal complications and birth outcomes.
Weiss
Harold B
HB
University of Pittsburgh, Department of Neurological Surgery, Center for Injury Research and Control, PARKV 203, 3520 Forbes Avenue, Pittsburgh, PA 15261, USA. weisshb@upmc.edu
Sauber-Schatz
Erin K
EK
Cook
Lawrence J
LJ
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D016001:Confidence Intervals; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014589:Utah / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*