title: Pregnancy course and outcome following blunt trauma.
abstract: OBJECTIVE
  To investigate short- and long-term outcome following blunt trauma in pregnancy, and to identify risk factors for adverse pregnancy outcome in these cases.
  
  
  METHODS
  A retrospective cohort study of all pregnant women who were admitted following blunt trauma (N=411). Women who experienced immediate complications (N=13) were compared with those who did not (N=398). Pregnancy outcome of women who experienced trauma during pregnancy and did not deliver during the trauma admission (N=303) were compared with a control group of women matched to by maternal age and parity in a 3:1 ratio (N=909).
  
  
  RESULTS
  The overall rate of immediate complications was 3.2%, with the most common complications being preterm labor (2.0%) and placental abruption (1.7%). Independent risk factors for immediate complications were higher severity of trauma, multiple gestation, vaginal bleeding and uterine contractions at admission. Patients who experienced trauma were at increased risk for long-term adverse outcome including preterm labor, placental abruption, and perinatal morbidity. Increased trauma severity (ISS ≥ 5) and the need for laparotomy during the trauma hospitalization were independently associated with long-term adverse pregnancy outcome.
  
  
  CONCLUSIONS
  Trauma during pregnancy is associated with both immediate and long-term adverse pregnancy outcome. Women who experience trauma should be followed more closely throughout pregnancy.
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Melamed
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
authors.forename: Michal
authors.initials: M
authors.lastname: Silver
authors.forename: Yoav
authors.initials: Y
authors.lastname: Peled
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.forename: Marek
authors.initials: M
authors.lastname: Glezerman
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
mesh_terms: D000328:Adult; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult