Maternal Outcomes After Trauma in Pregnancy: A National Database Study.

Abstract

Trauma is an important non-obstetric cause of mortality in pregnant females. The National Trauma Databank (NTDB) was queried between 2017 and 2018. Pregnant women >20weeks gestation, who underwent trauma, were included. They were categorized into different age groups from 12-18, 18-35, and 36-50years of age. The primary outcome measure was 30-day mortality. 1,058 pregnant trauma patients were included. Mean age was 26.7 ± 6years. Of those 94.5% had blunt and 3.8% had penetrating injuries. Median GCS and ISS were 15 (15, 15) and 2 (1, 5), respectively. Penetrating trauma patients required more operative intervention (57.5%) than blunt trauma patients (24.6%). Univariate analysis comparing age groups 12-18, 19-35, and >36years revealed differences. (P < .05) in ED systolic blood pressure (110.9 ± 19.7 vs 117.3 ± 20.3 vs 129.1 ± 29.3 mmHg, P = .01) and diabetes mellitus (.0 vs 2.7% vs 6.6% P = .03). There was no difference in HLOS (P = .72), complications (P = .279), and mortality (P = .32). Multivariate logistic regression analysis revealed that compared to patients 12-18 years old, patients 19 to 35 (P = .27) or those >36 (P = 1.0) did not show a significant difference in mortality. Patients with high ISS had higher complication rates (OR 1.09; 95% CI 1.04-1.15) and prolonged HLOS (OR 1.00; 95% CI 1.07-1.15). On average pregnant women (>20weeks gestation) who presented to trauma centers had minor injuries and maternal age or mechanism of injury did not affect mortality. Despite a low ISS, a significant number of these patients required operative procedures.