Pregnancy outcomes after orthopedic trauma.
BACKGROUND
This study was performed to determine the effects of orthopedic trauma on pregnancy outcomes in pregnant trauma patients.


METHODS
This was an observational study completed after electronically linking databases for the obstetric service and the trauma service at our Level I trauma center. All pregnant women who presented during the years 1995 to 2007 were eligible for inclusion. Selected pregnancy outcomes in women who delivered at our trauma center during or after their trauma admission were evaluated according to the presence of orthopedic injuries. Statistical analyses were performed using χ, Student's t test, and Wilcoxon rank-sum test; and p < 0.05 are considered statistically significant.


RESULTS
There were 65 pregnant women with orthopedic injuries (6%) and 990 without orthopedic injuries. Women with orthopedic trauma had an average gestational age of 28 weeks versus 31 weeks for women without orthopedic trauma. Compared with the patients without orthopedic injuries, patients with orthopedic injuries had a significant increased risk of preterm birth before 37 weeks of gestation (31% vs. 3%; p < 0.001), an increased risk of placental abruption (8% vs. 1%; p < 0.001), and an increased risk of perinatal mortality (8% vs. 1%; p < 0.001).


CONCLUSIONS
Our findings indicate that traumatized pregnant women with orthopedic injuries are high-risk obstetrical patients and may benefit from referral to a medical center capable of handling both the primary injury and the potential preterm birth associated with the injury.
Cannada
Lisa K
LK
Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA. lcannada@slu.edu
Pan
Ping
P
Casey
Brian M
BM
McIntire
Donald D
DD
Shafi
Shahid
S
Leveno
Kenneth J
KJ
D000077:Acetabulum / Q000293:injuries; D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D005260:Female; D005313:Fetal Death / Q000209:etiology; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D022125:Lacerations / Q000150:complications; D009104:Multiple Trauma / Q000150:complications; D010388:Pelvis / Q000293:injuries; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000150:complications*; D055815:Young Adult