Tags

Type your tag names separated by a space and hit enter

Profile of mothers at risk: an analysis of injury and pregnancy loss in 1,195 trauma patients.
J Am Coll Surg. 2005 Jan; 200(1):49-56.JA

Abstract

BACKGROUND

Trauma is the number one cause of maternal death during pregnancy, but incidence of fetal loss exceeds maternal loss by more than 3 to 1. We hypothesized that we could identify women at risk for injury during pregnancy and focus our prevention efforts.

STUDY DESIGN

Women of childbearing age in the American College of Surgeon's National Trauma Data Bank served as the study population. Pregnant patients were compared with nonpregnant patients with respect to age, race, mechanism of injury, injury patterns and severity, risk-taking behaviors, and outcomes. Multivariate logistic regression analysis was used to identify risk factors for loss of pregnancy in mothers who survived their trauma.

RESULTS

Pregnant trauma patients (n = 1,195) were younger, less severely injured, and more likely to be African American or Hispanic as compared with the nonpregnant cohort (n = 76,126). Twenty percent of injured pregnant patients tested positive for drugs or alcohol, and approximately one-third of those involved in motor vehicle crashes were not using seatbelts. Independent risk factors for fetal loss after trauma included Injury Severity Score > 15; Adjusted Injury Score > or = 3 in the head, abdomen, thorax, or lower extremities; and Glasgow Coma Score < or = 8.

CONCLUSIONS

Young, African-American, and Hispanic pregnant women are at higher risk for trauma in pregnancy and are most likely to benefit from primary trauma prevention efforts. Those with severe head, abdominal, thoracic, or lower extremity injuries are at high risk for pregnancy loss. Reduction of secondary insults and early recognition of fetal distress may improve outcomes for both the mother and fetus in this high-risk group.

Authors+Show Affiliations

Department of Surgery, University of California-San Francisco, and San Francisco Injury Center, San Francisco, CA 94110, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15631920

Citation

Ikossi, Danagra G., et al. "Profile of Mothers at Risk: an Analysis of Injury and Pregnancy Loss in 1,195 Trauma Patients." Journal of the American College of Surgeons, vol. 200, no. 1, 2005, pp. 49-56.
Ikossi DG, Lazar AA, Morabito D, et al. Profile of mothers at risk: an analysis of injury and pregnancy loss in 1,195 trauma patients. J Am Coll Surg. 2005;200(1):49-56.
Ikossi, D. G., Lazar, A. A., Morabito, D., Fildes, J., & Knudson, M. M. (2005). Profile of mothers at risk: an analysis of injury and pregnancy loss in 1,195 trauma patients. Journal of the American College of Surgeons, 200(1), 49-56.
Ikossi DG, et al. Profile of Mothers at Risk: an Analysis of Injury and Pregnancy Loss in 1,195 Trauma Patients. J Am Coll Surg. 2005;200(1):49-56. PubMed PMID: 15631920.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Profile of mothers at risk: an analysis of injury and pregnancy loss in 1,195 trauma patients. AU - Ikossi,Danagra G, AU - Lazar,Ann A, AU - Morabito,Diane, AU - Fildes,John, AU - Knudson,M Margaret, PY - 2004/05/19/received PY - 2004/09/22/revised PY - 2004/09/23/accepted PY - 2005/1/6/pubmed PY - 2005/2/18/medline PY - 2005/1/6/entrez SP - 49 EP - 56 JF - Journal of the American College of Surgeons JO - J Am Coll Surg VL - 200 IS - 1 N2 - BACKGROUND: Trauma is the number one cause of maternal death during pregnancy, but incidence of fetal loss exceeds maternal loss by more than 3 to 1. We hypothesized that we could identify women at risk for injury during pregnancy and focus our prevention efforts. STUDY DESIGN: Women of childbearing age in the American College of Surgeon's National Trauma Data Bank served as the study population. Pregnant patients were compared with nonpregnant patients with respect to age, race, mechanism of injury, injury patterns and severity, risk-taking behaviors, and outcomes. Multivariate logistic regression analysis was used to identify risk factors for loss of pregnancy in mothers who survived their trauma. RESULTS: Pregnant trauma patients (n = 1,195) were younger, less severely injured, and more likely to be African American or Hispanic as compared with the nonpregnant cohort (n = 76,126). Twenty percent of injured pregnant patients tested positive for drugs or alcohol, and approximately one-third of those involved in motor vehicle crashes were not using seatbelts. Independent risk factors for fetal loss after trauma included Injury Severity Score > 15; Adjusted Injury Score > or = 3 in the head, abdomen, thorax, or lower extremities; and Glasgow Coma Score < or = 8. CONCLUSIONS: Young, African-American, and Hispanic pregnant women are at higher risk for trauma in pregnancy and are most likely to benefit from primary trauma prevention efforts. Those with severe head, abdominal, thoracic, or lower extremity injuries are at high risk for pregnancy loss. Reduction of secondary insults and early recognition of fetal distress may improve outcomes for both the mother and fetus in this high-risk group. SN - 1072-7515 UR - https://www.unboundmedicine.com/medline/citation/15631920/Profile_of_mothers_at_risk:_an_analysis_of_injury_and_pregnancy_loss_in_1195_trauma_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1072-7515(04)01235-9 DB - PRIME DP - Unbound Medicine ER -