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Adverse pregnancy outcomes following motor vehicle crashes
Journal article   Open access   Peer reviewed

Adverse pregnancy outcomes following motor vehicle crashes

Catherine J Vladutiu, Stephen W Marshall, Charles Poole, Carri Casteel, M Kathryn Menard and Harold B Weiss
American journal of preventive medicine, Vol.45(5), pp.629-636
11/2013
DOI: 10.1016/j.amepre.2013.06.018
PMCID: PMC3859429
PMID: 24139777
url
https://doi.org/10.1016/j.amepre.2013.06.018View
Published (Version of record) Open Access

Abstract

Motor vehicle crashes are a leading cause of serious trauma during pregnancy, but little is known about their relationships with pregnancy outcomes. To estimate the association between motor vehicle crashes and adverse pregnancy outcomes. A retrospective cohort study of 878,546 pregnant women, aged 16-46 years, who delivered a singleton infant in North Carolina from 2001 to 2008. Pregnant drivers in crashes were identified by probabilistic linkage of vital records and crash reports. Poisson regression modeled the association among crashes, vehicle safety features, and adverse pregnancy outcomes. Analyses were conducted in 2012. In 2001-2008, 2.9% of pregnant North Carolina women were drivers in one or more crashes. After a single crash, compared to not being in a crash, pregnant drivers had slightly elevated rates of preterm birth (adjusted rate ratio [aRR]=1.23, 95% CI=1.19, 1.28); placental abruption (aRR=1.34, 95% CI=1.15, 1.56); and premature rupture of the membranes (PROM; aRR=1.32, 95% CI=1.21, 1.43). Following a second or subsequent crash, pregnant drivers had more highly elevated rates of preterm birth (aRR=1.54, 95% CI=1.24, 1.90); stillbirth (aRR=4.82, 95% CI=2.85, 8.14); placental abruption (aRR=2.97, 95% CI=1.60, 5.53); and PROM (aRR=1.95, 95% CI=1.27, 2.99). Stillbirth rates were elevated following crashes involving unbelted pregnant drivers (aRR=2.77, 95% CI=1.22, 6.28) compared to belted pregnant drivers. Crashes while driving during pregnancy were associated with elevated rates of adverse pregnancy outcomes, and multiple crashes were associated with even higher rates of adverse pregnancy outcomes. Crashes were especially harmful if drivers were unbelted.
 Humans Middle Aged Abruptio Placentae - epidemiology Abruptio Placentae - etiology Young Adult Seat Belts - statistics & numerical data Adult Female Retrospective Studies North Carolina - epidemiology Pregnancy Complications - etiology Fetal Membranes, Premature Rupture - etiology Fetal Membranes, Premature Rupture - epidemiology Premature Birth - epidemiology Premature Birth - etiology Pregnancy Regression Analysis Automobile Driving - statistics & numerical data Accidents, Traffic - statistics & numerical data Adolescent Stillbirth - epidemiology Poisson Distribution Pregnancy Complications - epidemiology Pregnancy Outcome Cohort Studies

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