Klinich Kathleen DeSantis, Flannagan Carol A C, Rupp Jonathan D, Sochor Mark, Schneider Lawrence W, Pearlman Mark D
University of Michigan Transportation Research Institute, Ann Arbor, MI, USA.
Am J Obstet Gynecol. 2008 Apr;198(4):450.e1-9. doi: 10.1016/j.ajog.2008.02.009.
This project was undertaken to improve understanding of factors associated with adverse fetal outcomes of pregnant occupants involved in motor-vehicle crashes.
In-depth investigations of crashes involving 57 pregnant occupants were performed. Maternal and fetal injuries, restraint information, measures of external and internal vehicle damage, and details about the crash circumstances were collected. Crash severity was calculated using vehicle crush measurements. Chi-square analysis and logistic regression models were used to determine factors with a significant association with fetal outcome.
Fetal outcome is most strongly associated with crash severity (P < .001) and maternal injury (P = .002). Proper maternal belt-restraint use (with or without airbag deployment) is associated with acceptable fetal outcome (odds ratio = 4.5, P = .033). Approximately half of fetal losses in motor-vehicle crashes could be prevented if all pregnant women properly wore seat belts.
Higher crash severity, more severe maternal injury, and lack of proper seat belt use are associated with a higher risk of adverse fetal outcome. These results strongly support recommendations that pregnant women use properly positioned seatbelts.
开展本项目以增进对与机动车碰撞事故中孕妇不良胎儿结局相关因素的理解。
对涉及57名孕妇的碰撞事故进行了深入调查。收集了母体和胎儿损伤情况、约束系统信息、车辆外部和内部损坏情况的测量数据以及碰撞事故情形的详细信息。使用车辆挤压测量数据计算碰撞严重程度。采用卡方分析和逻辑回归模型来确定与胎儿结局有显著关联的因素。
胎儿结局与碰撞严重程度(P <.001)和母体损伤(P =.002)关联最为密切。孕妇正确使用安全带约束系统(无论是否有安全气囊展开)与胎儿结局良好相关(优势比 = 4.5,P =.033)。如果所有孕妇都正确系好安全带,机动车碰撞事故中约一半的胎儿死亡可得以避免。
碰撞严重程度越高、母体损伤越严重以及未正确使用安全带与不良胎儿结局风险越高相关。这些结果有力地支持了关于孕妇使用位置正确的安全带的建议。