Long-term fetal outcomes in pregnant trauma patients

Sperry, Jason L.; Casey, Brian M.; McIntire, Donald D.; Minei, Joseph P.; Gentilello, Larry M.; Shafi, Shahid

doi:10.1016/j.amjsurg.2006.08.032

« Previous Next »The American Journal of Surgery
Volume 192, Issue 6 , Pages 715-721, December 2006

Long-term fetal outcomes in pregnant trauma patients

Presented at the 58th Annual Meeting of the Southwestern Surgical Congress, Kauai, Hawaii, April 3–7, 2006

Jason L. Sperry, M.D.
- Department of Surgery, Division of Burns, Trauma and Surgical Critical Care, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Mail Stop 9158, Dallas, TX 75390-9158, USA
Brian M. Casey, M.D.
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Donald D. McIntire, Ph.D.
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Joseph P. Minei, M.D.
- Department of Surgery, Division of Burns, Trauma and Surgical Critical Care, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Mail Stop 9158, Dallas, TX 75390-9158, USA
Larry M. Gentilello, M.D.
- Department of Surgery, Division of Burns, Trauma and Surgical Critical Care, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Mail Stop 9158, Dallas, TX 75390-9158, USA
Shahid Shafi, M.D., M.P.H.
- Department of Surgery, Division of Burns, Trauma and Surgical Critical Care, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Mail Stop 9158, Dallas, TX 75390-9158, USA
- Corresponding author. Tel.: +1-214-648-7214; fax: +1-214-648-5477.

Received 15 April 2006; received in revised form 10 August 2006

Abstract

Background

Trauma during pregnancy is associated with significant maternal and fetal morbidity and mortality, typically occurring during the hospital admission. Less is known about the delayed effects of trauma on pregnancy outcome once the patient has been discharged from the hospital with a viable fetus.

Methods

A retrospective cohort study was conducted of pregnant trauma patients who were discharged from the trauma center with a viable fetus. Risk of preterm delivery (PTD) and low birth weight (LBW) were compared between injured patients (Injury Severity Score > 0) and those without identified injury (Injury Severity Score = 0), for the remainder of pregnancy.

Results

Even after trauma center discharge, injured patients had a nearly 2-fold higher risk of PTD (relative risk, 1.9; 95% confidence interval, 1.1–3.3) and LBW (relative risk, 1.8; 95% confidence interval, 1.04–3.2) for the remainder of the pregnancy. The risk was higher with increasing injury severity and among those injured early in gestation.

Conclusion

The risk of PTD and LBW in pregnant trauma patients who were discharged from trauma centers with a viable fetus remains increased throughout the remainder of the pregnancy. A history of trauma during gestation is a risk factor for poor pregnancy outcome.

Keywords: Trauma, Pregnancy, Injury, Delayed, Preterm delivery, Low birth weight