(864) Trauma in Pregnancy: Perinatal Outcomes at a Level I Trauma Center

Traumatic injury during pregnancy is a leading cause of non-obstetric maternal and fetal morbidity and mortality. However, the association between the most severe traumatic injuries and adverse pregnancy outcomes (APOs) remains understudied.  The aim of this study was to investigate the effects of severe traumatic injury during pregnancy on maternal and fetal outcomes in a high-risk patient population.
 

Study Design:
This retrospective cohort study examined all pregnancies with admission encounters at an urban safety net hospital between 2016 – 2022. Traumatic injury during pregnancy was defined as a pregnancy with an ICD-10 diagnosis and procedure code denoting trauma during pregnancy as well as an associated imaging encounter, in order to more accurately identify the most severe traumas. APOs were identified using ICD-10 diagnosis and procedure codes. Multivariable logistic regression was performed adjusting for maternal age, body mass index, parity, and race/ethnicity.

 

Results:
Of N=11,181 pregnancies included in this analysis, n= 130 (1.2%) experienced a severe traumatic injury. 9% of the pregnancies with traumatic injury required hospitalization at the time of the event. Patients who experienced trauma had an increased odds of cesarean delivery (aOR 1.92 (1.18, 3.15)), preterm labor (aOR 2.26 (1.25, 4.09)), preterm birth (aOR 2.52 (1.48, 4.29)), placental abruption (aOR 4.47 (1.57, 12.74)), and Neonatal Intensive Care Unit (NICU) stay >3 days (aOR 1.86 (1.09, 3.19)) as compared to patients who did not experience severe trauma. (Table)

 

Conclusion:
Traumatic injury during pregnancy severe enough to warrant diagnostic imaging was associated with an increased odds of APOs. These data support the need for early identification and multidisciplinary management of trauma in pregnant individuals.