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. Conclusion: 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.