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Poster Session 3

(867) Maternal Trauma in Pregnancy - How Bad Are the Consequences?

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Nata T. Willner, BSc, MD (she/her/hers)

    OBGYN resident
    Soroka University Medical Center
    Soroka University Medical Center, HaDarom, Israel

    • Coauthor(s)

  • NN

    Nitza Newman, MD

    Soroka University Medical Center
    Be'er Sheva, HaDarom, Israel

  • Tamar Wainstock, PhD (she/her/hers)

    Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Beer Sheva, HaDarom, Israel

  • Eyal Sheiner, MD, PhD

    Head of department of Obstetrics and Gynecology, Soroka University Medical Center
    Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Beer Sheva, HaDarom, Israel

Objective:

Abdominal trauma during pregnancy may compromise placental perfusion and fetal wellbeing. This study aimed to assess perinatal outcomes following abdominal trauma due to motor vehicle accidents (MVA) and falls.

Study Design: This population-based cohort study included all pregnant women presenting to a tertiary-care center emergency room between the years 1991-2021. Trauma victims were categorized as vehicle occupant MVA, pedestrian MVA, or following a fall. Comorbidities and pregnancy outcomes were compared between patients with and without trauma. Generalized estimation equation (GEE) models were used to control for confounders such as maternal age and gravidity.

Results:

A total of 356,356 births were recorded, including 66 (0.02%) following vehicle occupant MVA, 46 (0.01%) following pedestrian MVA, and 142 (0.04%) following a fall.  Placental abruption, non-reassuring fetal heart rate (NRFHR), preterm delivery and perinatal mortality were all more common among trauma patients. After controlling for maternal age and gravidity, using GEE models, abdominal trauma was significantly associated with placental abruption (adjusted OR 21.7 for vehicle occupant MVA, adjusted OR 4.7 for pedestrian MVA, OR 2.5 for fall), NRFHR (adjusted OR 3.6 for vehicle occupant MVA, adjusted OR 2.6 for pedestrian MVA, adjusted OR 1.6 for fall), and preterm delivery (adjusted OR 4.1 for vehicle occupant MVA, adjusted OR 1.2 for pedestrian MVA, adjusted OR 2.8 for fall) as compared to non-trauma parturients. Perinatal mortality was higher among vehicle occupant MVA (adjusted OR 9.8) and fall (adjusted OR 4.0) than among non-trauma parturients (Table).

Conclusion:

Abdominal trauma during pregnancy is an independent risk factor for adverse perinatal outcomes. The greatest risk seems to be among occupants of a vehicle involved in a collision.