Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Department of Epidemiology, Biostatistics and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.
JAMA Netw Open. 2021 Apr 1;4(4):e217072. doi: 10.1001/jamanetworkopen.2021.7072.
Literature has suggested that trauma among pregnant women is associated with an increased risk of adverse pregnancy outcomes. However, limited research has investigated the association of trauma with adverse pregnancy outcomes by using a national data set.
To investigate the association between traumatic injury and adverse pregnancy outcomes.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study of pregnant women in Taiwan linked 3 data sets, the Taiwan Birth Registry, Household Registration Information, and National Health Insurance Research Database, from January 1, 2004, through December 31, 2014. Data, including the characteristics of pregnant women and infants, were extracted from the Taiwan Birth Registry data set; to obtain trauma data, this data set and the Household Registration Information data set were collectively linked to National Health Insurance Research Database data. The combined data set was analyzed from January to July 2019. Adverse pregnancy outcomes and premature delivery were defined using International Classification of Diseases, Ninth Revision, Clinical Modification codes.
The primary exposures of this study were 2 clinical variables related to injury during pregnancy: medical treatment in the emergency department (yes or no) and hospitalization (yes or no).
The main outcome variable was adverse pregnancy outcomes, and the secondary outcome variable was premature delivery. Multivariate logistic regression models were used to investigate the association of injuries with adverse pregnancy outcomes after controlling for demographic characteristics and other pregnancy-related variables.
A total of 2 973 831 pregnant women (2 475 805 [83.3%] aged 20-34 years) were enrolled between 2004 and 2014, of whom 59 681 (2.0%) sought medical treatments due to injuries. Results of multivariate logistic regression models showed that women receiving emergency treatments more than once were 1.08 times as likely (adjusted odds ratio, 1.08; 95% CI, 1.05-1.10) to have adverse pregnancy outcomes than women who received no emergency treatment. Women with injury-related hospitalization were 1.53 times more likely (adjusted odds ratio, 1.53; 95% CI, 1.41-1.65) to have adverse pregnancy outcomes than women who did not sustain injuries. Furthermore, recurrent injuries were associated with a 572% increase in odds of premature delivery (adjusted odds ratio, 6.72; 95% CI, 2.86-15.80).
In this study, trauma among pregnant women was associated with an increased risk of adverse pregnancy outcomes, as were hospitalization and emergency department visits due to injury.
文献表明，孕妇创伤与不良妊娠结局风险增加有关。然而，利用国家数据集研究创伤与不良妊娠结局之间的关联的研究有限。
调查创伤与不良妊娠结局之间的关联。
设计、地点和参与者：这项基于人群的台湾孕妇队列研究将 3 个数据集进行了链接，包括 2004 年 1 月 1 日至 2014 年 12 月 31 日的台湾出生登记处、户籍信息和国家健康保险研究数据库。孕妇和婴儿特征等数据均从台湾出生登记处数据集中提取；为了获取创伤数据，该数据集和户籍信息数据集被联合链接到国家健康保险研究数据库的数据中。综合数据集于 2019 年 1 月至 7 月进行了分析。本研究的主要暴露因素为 2 个与妊娠期间受伤相关的临床变量：急诊治疗（是或否）和住院治疗（是或否）。
主要结局变量为不良妊娠结局，次要结局变量为早产。采用多变量逻辑回归模型，在控制人口统计学特征和其他妊娠相关变量后，调查了受伤与不良妊娠结局之间的关联。
共纳入 2973831 名孕妇（2475805 名[83.3%]年龄为 20-34 岁），其中 59681 名（2.0%）因受伤接受了医疗治疗。多变量逻辑回归模型的结果显示，多次接受急诊治疗的女性发生不良妊娠结局的可能性是未接受急诊治疗的女性的 1.08 倍（调整后优势比，1.08；95%CI，1.05-1.10）。因受伤相关住院治疗的女性发生不良妊娠结局的可能性是未受伤女性的 1.53 倍（调整后优势比，1.53；95%CI，1.41-1.65）。此外，反复受伤与早产几率增加 572%相关（调整后优势比，6.72；95%CI，2.86-15.80）。
在这项研究中，孕妇创伤与不良妊娠结局风险增加有关，因受伤而住院和到急诊室就诊也是如此。
