Azar Tania, Longo Cristina, Oddy Lisa, Abenhaim Haim Arie
Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Canada.
Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Canada.
J Obstet Gynaecol Res. 2015 Sep;41(9):1370-6. doi: 10.1111/jog.12745. Epub 2015 Jul 14.
Motor vehicle accidents (MVA) are a major contributor of worldwide morbidity and mortality; however, relatively little is known about the incidence and consequences of traffic accidents on pregnant women. Our aim is to compare rates and outcomes of motor vehicle collision-related accidents in pregnant women.
We conducted a population-based retrospective cohort study using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database from 2003 to 2011. The risk of different MVA and injuries were compared among pregnant and non-pregnant subjects using conditional logistic regression.
We identified 5936 cases of collision-related MVA in pregnancy and age-matched them at a 1:10 ratio to 59,360 non-pregnant women with collision-related MVA. As compared to non-pregnant women, pregnant women who were admitted after an MVA suffered less severe injuries and consequently required fewer therapeutic interventions and a shorter hospital stay. Pregnant women who had a collision-related MVA were, however, at increased risk of requiring genitourinary surgery (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.24-1.69). When restricted to women with a fracture, pregnant women were even more likely to require genitourinary surgery (OR, 2.93; 95%CI, 2.32-3.71) as well as require a blood transfusion (OR, 1.21; 95%CI, 1.01-1.44).
Pregnant women admitted to hospital after a collision-related MVA tend to sustain less severe injuries compared to non-pregnant women. However, the influence of admissions for fetal monitoring, rather than maternal injury, could not be determined from our dataset. Pregnant women who experienced a collision-related MVA also required less surgical intervention, with the exception of genitourinary surgery, which may be indicative of more cesarean deliveries.
机动车事故(MVA)是全球发病和死亡的主要原因;然而,关于交通事故对孕妇的发生率和后果相对知之甚少。我们的目的是比较孕妇机动车碰撞相关事故的发生率和结局。
我们使用2003年至2011年医疗保健成本和利用项目全国住院患者样本数据库进行了一项基于人群的回顾性队列研究。使用条件逻辑回归比较孕妇和非孕妇中不同机动车事故和损伤的风险。
我们确定了5936例妊娠期间与碰撞相关的机动车事故病例,并以1:10的比例将其与59360例年龄匹配的非孕妇碰撞相关机动车事故病例进行匹配。与非孕妇相比,机动车事故后入院的孕妇受伤较轻,因此需要的治疗干预较少,住院时间较短。然而,发生与碰撞相关机动车事故的孕妇接受泌尿生殖系统手术的风险增加(优势比[OR],1.45;95%置信区间[CI],1.24 - 1.69)。当仅限于有骨折的女性时,孕妇更有可能需要泌尿生殖系统手术(OR,2.93;95%CI,2.32 - 3.71)以及输血(OR,1.21;95%CI,1.01 - 1.44)。
与碰撞相关机动车事故后入院的孕妇与非孕妇相比,受伤往往较轻。然而,从我们的数据集中无法确定胎儿监测入院而非母体损伤的影响。经历与碰撞相关机动车事故的孕妇除泌尿生殖系统手术外也需要较少的手术干预,这可能表明剖宫产分娩较多。