Clinical presentations, management, and outcomes of trauma in pregnancy: A retrospective observational study

Background

Trauma poses significant risks during pregnancy, leading to adverse outcomes. We aimed to evaluate the impact of trauma during pregnancy on maternal and fetal outcomes.

Material and methods

A retrospective observational study was performed involving all pregnant women presented to a national trauma center (2015- 2021). Univariate and multivariate analyses were done to assess the trauma-related variables and to identify predictors of adverse outcomes (birthweight <2.5 kg, premature delivery, and neonatal death).

Results

A total of 566 pregnant women with trauma were included in the analysis. The patients mean age was 29.6 (SD 5.4) years, and motor vehicle collisions (MVCs) were the most frequent mechanism of injury (60.1 %). Approximately 41 % of the MVC victims (139/342) were wearing protective devices. Extremity injuries were the most common type of injury (25.7 %). The mean gestational age at the time of injury was 23.3 (9.4) weeks. Fetal distress, fetal death, and neonatal death occurred infrequently, ranging from 0.2 % to 4.6 %. Overall, 12.9 % of pregnancies resulted in adverse outcomes. In the multivariable model, hypertension (OR= 9.1, p = 0.001), diabetes mellitus (OR= 5.7, p = 0.006), placental abruption (OR = 23.4, p = 0.001), a history of previous C-section (OR = 3.4, p = 0.008) and gestational age at the time of injury (OR = 2.6, p = 0.001) were associated with an increased likelihood of adverse pregnancy outcomes.

Conclusion

This study revealed that trauma during pregnancy is associated with adverse pregnancy outcomes, therefore, these patients should be monitored carefully. Further research is needed to explore how trauma impacts pregnancy progression and fetal well-being, and public health interventions/awareness campaigns highlighting the importance of preventive measures should target pregnant women.