# Maternal and Fetal Outcomes of Motor Vehicle-Related Trauma in Pregnancy: A Trauma Center Study

## TL;DR

This study examines how motor vehicle collisions affect pregnant women, finding that higher car speeds are linked to more severe injuries, but most injuries were minor due to seat belt use.

## Contribution

The study identifies car speed as a key predictor of injury severity in pregnant trauma patients, while highlighting the protective role of seat belts.

## Key findings

- Higher car speed was significantly associated with intra-abdominal injury and skin lacerations.
- Most patients had no or minor injuries, likely due to high seat belt usage.
- Pregnant individuals with higher parity tended to be involved in crashes at lower speeds.

## Abstract

Objective

The main objective of this study is to examine immediate outcomes, and the incidence of severe intra-abdominal injury after motor vehicle collisions (MVCs) in the pregnant population.

Methods

We conducted a retrospective cohort study. From 2015 to 2021, all pregnant patients who presented to a level I trauma center within 24 hours of MVC were included. Data on patient characteristics, collision details, hospital workup, and trauma-related injuries were extracted from their charts using ICD-10 code O9A.21. Descriptive statistics were used to summarize data. General linear models and univariate logistic regression models were used to analyze the relationship between variables.

Results

The study included 157 pregnant patients. Most were in their mid-20s, overweight to obese, multiparous, Hispanic, and in the second trimester. The median reported car speed was 30 mph (IQR 10-45 mph); 99% (N = 155) of patients reported use of seat belts, and 70% (N = 111) were drivers. Most collisions were hit from side. Airbags were deployed in 66% (N = 104) of collisions, and airbag deployment was significantly associated with a higher car speed (p < 0.01); 13% (N = 20) of patients had seat belt signs, and only 1% (N = 2) had peritoneal signs leading to exploratory laparotomy, while 85% (N = 133) of patients had no or minor injuries. Univariate logistic regression analysis showed car speed was significantly associated with intra-abdominal injury (p = 0.02). Car speed also independently predicted skin lacerations (p < 0.01) and length of hospital stay (p < 0.01), but not bony fractures (p = 0.15). Car speed did not vary with gestational age or maternal age. A trend was observed that pregnant individuals with increasing parity were involved in MVCs at lower car speeds.

Conclusion

In our study, a higher car speed is the main factor associated with increased injury severity, but not with the deployment of airbags. The majority of patients experienced no or only minor injuries, likely due to the high rate of seat belt use. Pregnant individuals with higher parity tended to be involved in crashes at lower speeds.