title: Perinatal implications of motor vehicle accident trauma during pregnancy: identifying populations at risk.
abstract: OBJECTIVE
  The purpose of this study was to examine the association between restraint use, race, and perinatal outcome after motor vehicle accidents (MVAs) during pregnancy.
  
  
  METHODS
  The Duke Trauma Registry and medical records were searched for information on pregnant women at >14 weeks' gestation who were involved in an MVA and who received care through the Emergency Department and the Obstetric Units. Between January 1994 and December 31, 2010, 126 women were identified. Variables that were collected included type of trauma, gestational age at presentation, and delivery outcomes. A prognostic study was performed that evaluated the associations between maternal demographics, details of the accident that included restraint use, and maternal treatment that was related to the accident in relationship to perinatal outcome.
  
  
  RESULTS
  There was no difference in the mean age or median gravidity or parity by race among pregnant women who were cared for after an MVA. There was no difference in mean age or racial distribution between women who were restrained compared with women who were unrestrained; unrestrained women were more likely to be nulliparous. Unrestrained women were more likely to require nonobstetric surgery that was related to the trauma. The overall rate of placental abruption was 6%. There were 6 intrauterine fetal deaths, 3 each in the unrestrained (25%) and restrained groups (3.5%; P = .018). Airbags deployed in 17 accidents. Among the 7 women with placenta abruption, 4 women (57%) experienced air bag deployment.
  
  
  CONCLUSIONS
  Lack of restraint use during pregnancy is associated with an increased risk of fetal death.
authors: Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
authors: Tomas
authors: T
authors: Luley
authors: C Brennan
authors: CB
authors: Fitzpatrick
authors: Chad A
authors: CA
authors: Grotegut
authors: Michael B
authors: MB
authors: Hocker
authors: Evan R
authors: ER
authors: Myers
authors: Haywood L
authors: HL
authors: Brown
mesh_terms: D000037:Abruptio Placentae / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017278:Air Bags / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology; D006801:Humans; D008499:Medical Records; D018986:Motor Vehicles; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D044469:Racial Groups; D012042:Registries; D012307:Risk Factors; D012622:Seat Belts / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D055815:Young Adult