Hyde Lisa K, Cook Lawrence J, Olson Lenora M, Weiss Harold B, Dean J Michael
Department of Pediatrics, The Intermountain Injury Control Research Center, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Obstet Gynecol. 2003 Aug;102(2):279-86. doi: 10.1016/s0029-7844(03)00518-0.
To assess the effect of maternal involvement in motor vehicle crashes on the likelihood of adverse pregnancy outcomes and to estimate the effect of seatbelt use in reducing the occurrence of those outcomes.
Statewide motor vehicle crash, birth, and fetal death records from 1992 to 1999 were probabilistically linked. Logistic regression was used to compare the likelihood of adverse birth and fetal outcomes including low birth weight, prematurity, placental abruption, fetal distress, excessive bleeding, fetal death, and other complications among pregnant women in crashes and those not in crashes.
Of 322,704 single live resident births, 8938 mothers (2.8%) experienced a crash during pregnancy. Pregnant women using seatbelts were not significantly more at risk for adverse fetal outcomes than pregnant women not in crashes. However, pregnant women who did not wear seatbelts during a crash were 1.3 times more likely to have a low birth weight infant than pregnant women not in a crash (95% confidence interval [CI] 1.0, 1.6) and twice as likely to experience excessive maternal bleeding than belted pregnant women in a crash (95% CI 1.0, 4.2). Forty-five of 2645 fetal deaths were linked to a motor vehicle crash, with unbelted pregnant women 2.8 times more likely to experience a fetal death than belted pregnant women in crashes (95% CI 1.4, 5.6).
Pregnant women should be counseled to wear seatbelts throughout pregnancy and reduce crash risk.
评估孕妇卷入机动车碰撞事故对不良妊娠结局可能性的影响，并估计使用安全带在减少这些结局发生方面的作用。
对1992年至1999年全州范围内的机动车碰撞事故、出生和胎儿死亡记录进行概率关联。采用逻辑回归比较碰撞事故中孕妇与未发生碰撞事故孕妇出现不良出生和胎儿结局的可能性，这些结局包括低出生体重、早产、胎盘早剥、胎儿窘迫、大出血、胎儿死亡及其他并发症。
在322,704例单胎常住活产中，8938名母亲（2.8%）在孕期经历了碰撞事故。使用安全带的孕妇出现不良胎儿结局的风险并不显著高于未发生碰撞事故的孕妇。然而，碰撞事故中未系安全带的孕妇生出低出生体重婴儿的可能性是未发生碰撞事故孕妇的1.3倍（95%置信区间[CI] 1.0, 1.6），发生碰撞事故时出现大出血的可能性是系安全带孕妇的两倍（95% CI 1.0, 4.2）。2645例胎儿死亡中有45例与机动车碰撞事故有关，碰撞事故中未系安全带的孕妇发生胎儿死亡的可能性是系安全带孕妇的2.8倍（95% CI 1.4, 5.6）。
应建议孕妇在整个孕期佩戴安全带并降低碰撞事故风险。
