title: Are pregnant women safer in motor vehicle accidents?
abstract: OBJECTIVE
  Motor vehicle accidents (MVAs) are a major incidental cause of pregnancy-associated maternal deaths in the US. The goal of this research was to evaluate the incidence, risks, and fetal and maternal outcomes of pregnant women involved in MVAs. In addition, we examined the relationship between the injury severity score (ISS) and car seat location in pregnant and non-pregnant women.
  
  
  METHODS
  This involved a retrospective cohort study of female patients who were involved in MVAs and hospitalized between the years 2006 and 2013. Data were collected from the Israeli National Trauma Registry. Severity and outcomes of pregnant and non-pregnant women with blunt trauma were compared.
  
  
  RESULTS
  In this study, 3794 pregnant and 3441 non-pregnant patients aged 18-40 years were analyzed. The majority of pregnant patients were drivers (n=2515, 67%) as opposed to passengers (n=1279, 33%). Pregnant patients had lower ISS than non-pregnant patients (P<0.001). Out of these pregnant patients, 38 (1%) had adverse maternal-fetal pregnancy outcomes, including (1) placental abruption 0.1% and (2) miscarriage (0.2%). One pregnant patient died (0.03%) compared with 32 (0.93%) of the non-pregnant patients (P<0.0001). A significant negative correlation between gestational age and spontaneous abortion was found (P<0.009).
  
  
  CONCLUSIONS
  The severity of injury and the mortality rate of pregnant patients involved in MVAs are significantly lower compared with non-pregnant patients. Pregnant drivers had a significantly lower severity of trauma compared with pregnant passengers.
authors.forename: Netanella
authors.initials: N
authors.lastname: Miller
authors.forename: Tal
authors.initials: T
authors.lastname: Biron-Shental
authors.forename: Kobi
authors.initials: K
authors.lastname: Peleg
authors.forename: Ami
authors.initials: A
authors.lastname: Fishman
authors.forename: Oded
authors.initials: O
authors.lastname: Olsha
authors.forename: Adi
authors.initials: A
authors.lastname: Givon
authors.forename: Boris
authors.initials: B
authors.lastname: Kessel
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality; D000293:Adolescent; D000328:Adult; D001334:Automobile Driving; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008428:Maternal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology* / Q000401:mortality; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000150:complications* / Q000209:etiology / Q000401:mortality; D055815:Young Adult