Poster Session 4
Timothy Wen, MD, MPH (he/him/his)
Assistant Professor
University of California, San Diego
Irvine, California, United States
Brittany Arditi, MD, MSCR
Clinical Fellow
Columbia University Irving Medical Center
New York, NY, United States
Cynthia Gyamfi-Bannerman, MD, MS (she/her/hers)
Professor and Chair
University of California, San Diego
San Diego, California, United States
Adina R. Kern-Goldberger, MD, MPH, MSCE
Assistant Professor
Cleveland Clinic Lerner College of Medicine
Cleveland, Ohio, United States
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Nasim C. Sobhani, MD, MS
Assistant Professor
UCSF
San Francisco, California, United States
Teresa C. Logue, MD, MPH (she/her/hers)
OB/GYN Resident
Christiana Care Health System
Newark, DE, United States
Maria Andrikopoulou, MD
Assistant Professor
Columbia University Irving Medical Center
New York, New York, United States
Chia-Ling Nhan-Chang, MD
University of California, San Diego
San Diego, California, United States
Alexander M. Friedman, MD, MPH
Professor of Obstetrics and Gynecology
Columbia University Irving Medical Center
New York, New York, United States
Kartik K. Venkatesh, MD, PhD (he/him/his)
Associate Professor
The Ohio State University
Columbus, Ohio, United States
Firearm violence is a preventable public health crisis in the United States and a primary cause of maternal mortality, but its national impact on perinatal outcomes remains to be fully examined. We examined trends in firearm-related injuries (FRI) during pregnancy, and their association with severe maternal morbidity (SMM) and adverse pregnancy outcomes (APOs).
Study Design: We utilized all delivery hospitalizations in the Nationwide Inpatient Sample from 2017-2021. The exposure was any firearm-related injuries at delivery hospitalization. We analyzed trends of FRI overall. The primary outcome was non-transfusion severe maternal morbidity (ntSMM) and secondarily SMM with transfusion, inpatient mortality, stillbirth, critical care procedures, and preterm birth < 37 weeks. We evaluated the association between FRI and perinatal outcomes using survey-adjusted logistic regression models, adjusting for demographic factors, hospital factors, delivery year, and obstetric comorbidity score.
Results:
Among 17.5 million deliveries, 6,365 were complicated by FRI at a rate of 3.6 per 10,000 delivery hospitalizations. Deliveries with FRI significantly increased from 2.7 to 3.6 per 10,000 delivery hospitalizations from 2017 to 2021 (p< 0.01), with a peak of 5.0 per 10,000 delivery hospitalizations in 2020 [Figure 1]. In adjusted analyses, FRI was associated with over a five-fold increased likelihood of ntSMM (5.1% vs 0.8%; aOR 5.21, 95% CI: 3.91, 6.95). In addition, FRI was associated with higher likelihood of adverse of all APOs, with the highest likelihood of needing critical care procedures (aOR 8.47, 95% CI: 4.64, 15.44) and inpatient mortality (aOR 19.19, 95% CI: 4.66, 79.07) [Figure 2].
Conclusion: Firearm-related injury at delivery hospitalization has increased across the US from 2017 to 2021 and is associated with an increased risk of SMM as well as APOs. Preventing gun violence has the potential reduce perinatal morbidity and mortality and should be an urgent public health priority.
