Pregnant women involved in road traffic collisions have an increased risk of serious birth complications, even if they suffer only minor injuries, researchers report today.
The study, led by Ya-Hui Chang, of the National Cheng Kung University, in Tainan, found the risks are even higher for those who are injured on scooters rather than in cars.
It could lead to a heightened risk of potentially serious birth complications, including placental abruption, very heavy bleeding and the need for a caesarean section.
The researchers used data supplied to the National Birth Notification (BN) Database in Taiwan, medical insurance claims, and death registry data between 2007 and 2016.
During the study period, 20,844 births were recorded among 20,739 women involved in a road traffic collision while pregnant.
Each of these women was matched with four randomly selected women, of the same age and at the same stage of pregnancy, but who had not been involved in a road traffic collision – a total of 83,274 controls.
Writing in the latest edition of Injury Prevention, the team said w omen who had been involved in road traffic collisions were more likely to live in rural areas, to be financially disadvantaged, and to have engaged in risky behaviours during their pregnancy.
Compared with their peers, these women were 51% more likely to have placental abruption, 31% more likely to experience prolonged contractions, 19% to bleed very heavily before birth and 5% more likely to need a caesarean section.
The study also found pregnant women needing emergency care or who had been admitted to hospital within three days of the collision were 77% and nearly six times more likely, respectively, to suffer placental abruption. They were at significantly higher risk of heavy bleeding before birth, having to have a caesarean section and delivering underweight babies.
Women who had been severely injured in the collision were four times as likely to experience placental abruption, 61% more likely to need a caesarean section, and 80% more likely to deliver prematurely than those who had not been injured.
Women with minor injuries were 70% more likely to suffer placental abruption, 54% more likely to have an induced labour and 34% more likely to have prolonged contractions.
Pregnant women riding scooters when in a collision had significantly higher risks of birth complications, ranging from 6% for caesarean section to 83% for placental abruption, than those injured in cars.
The researchers said: “These findings reinforce the fact that healthcare workers should be aware of these effects and consider providing pregnant women with educational materials about road traffic safety and choice of vehicle while travelling during pregnancy,” write the researchers.
“Given the associations observed, a better understanding is needed in future research of the circumstance following crashes during pregnancy in order to develop effective management.”
Chang Y-H, Chien Y-W, Chang C-H et al. Maternal outcomes in association with motor vehicle crashes during pregnancy: a nationwide population based retrospective study. Injury Prevention 21 March 2023
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