Burn Injuries During Pregnancy in Iran

Abstract

The mortality rate is high for pregnant burn victims and their fetuses. This retrospective study assessed the maternal and fetal outcome of burn injuries in pregnant women treated at a burn center in Iran between 2001 and 2007. The investigators stratified the patients by maternal age, level of education, marital status, percentage of the total body surface area (TBSA) burned, presence or absence of inhalation injury, cause of burn, trimester of pregnancy in which the burn occurred, and whether the burn was intentional (suicidal). Of the 4090 women treated during the study period, 53 (1.3%) were pregnant at the time of admission. The mean age of the pregnant women was 22.9 ± 5.3 years; over 90% were younger than 30 years. Among the 40 pregnant women with inhalation injuries, there were 27 maternal deaths (67.5%) and 28 fetal deaths (70%), which was significantly higher than among those without inhalation injury (7.7% maternal deaths and 15.4% fetal deaths, P = 0.001 for both). The mean percentages of TBSA burned were significantly higher in women and fetuses who died than in survivors (P < 0.001 for both). The burn was intentional in 18 (34%) of the 53 pregnant women. No significant difference was found in the rate of inhalation injury between women with and without intentional bums. When the burn injury was the result of suicidal intent, the mean percentage of TBSA burned was significantly higher (66.5% ± 23.8% in suicidal patients versus 45.3% ± 26.3% in nonsuicidal patients) (P = 0.006), and the maternal and fetal mortality rates were higher (83.3% vs. 37.1%, P = 0.001 and 83.3% vs. 42.9% P = 0.005, respectively). There was no correlation between suicide attempts and pregnancy trimester. The data show that maternal and fetal mortality rates are higher for burned women who are pregnant compared to nonpregnant women. The investigators conclude from these findings that inhalation injury, a higher percentage of TBSA burned, and suicidal intent are poor prognostic factors for pregnant women with burn injuries.