Pregnancy-Associated Injury Hospitalizations in Pennsylvania, 1995

Abstract

Study objective: To estimate the frequency of pregnancy-associated injury hospitalization and compare rates between pregnant women and all women of reproductive age by age, race, injury mechanism, intent, and other variables. Methods: Using International Classification of Diseases, Ninth Revision—Clinical Modification (ICD-9-CM) selection criteria applied to Pennsylvania’s 1995 acute hospital discharge data, all resident women ages 15 to 44 with coexistent pregnancy and injury-related diagnoses were identified for descriptive and comparative rate calculations. Results: Seven hundred sixty-one (4.6%) of the discharges to injured women of reproductive age were associated with pregnancy. The leading injury causes among pregnant women were transportation-related (234 [33.6%]), falls (192 [26.4%]), poisonings (116 [16.0%]), and “struck by” (83 [11.4%]). Among all women 15 to 44 years, poisoning was the leading cause (32.6%) of injury, followed by transportation-related injuries (25.7%). The hospitalized injury incidence was 868 per 100,000 person-years for pregnant women versus 641 for all women ages 15 to 44 (rate ratio 1.35, 95% confidence interval [CI] 1.25 to 1.45). Pregnant women were younger (median age 24.9 years versus 30.0 years), their mean length of stay was shorter (2.5 days versus 3.7 days), the mean injury severity score was less (3.2 versus 4.8), and the median charge per stay was lower ($4,164 versus $6,051). Rate ratios (pregnant versus all women in same age group) were significantly higher for younger women 15 to 19 years (rate ratio 2.69, 95% CI 2.49 to 3.14). Rate ratios were significantly higher for assaults (rate ratio 3.04, 95% CI 2.45 to 3.78), falls (rate ratio 2.33, 95% CI 2.01 to 2.70), motor vehicle occupant (rate ratio 2.0, 95% CI 1.73 to 2.31), and struck by (rate ratio 3.73, 95% CI 2.97 to 4.69). Rate ratios were lower for poisonings (rate ratio 0.71, 95% CI 0.59 to 0.86) and self-inflicted injuries (rate ratio 0.62, 95% CI 0.50 to 0.77). Conclusion: Pregnant women were more likely than all women 15 to 44 years to be hospitalized for injury and more likely to be hospitalized for assaults, falls, transportation-related, and less severe injuries, but less likely for poisonings and self-inflicted injuries. Much of the increased risk appears to be concentrated in young women. Further work is needed to establish to what extent the observed increases are the result of increased injury rates or increased hospitalization rates. [Weiss HB: Pregnancy-associated injury hospitalizations in Pennsylvania, 1995. Ann Emerg Med November 1999;34:626-636.]