Trauma Evaluation During Pregnancy Is Independently Associated With Adverse Perinatal Outcomes Regardless of Injury Presence and Severity [ID 1256]

Introduction: Trauma complicates approximately 8% of pregnancies. It is the leading nonobstetrical cause of maternal death and poses significant fetal risk. We hypothesize that a need for trauma evaluation during pregnancy, regardless of injury, is a potential marker for adverse perinatal outcomes. Methods: A single-institution retrospective cohort review was performed of pregnant patients from 2010 to 2020 who sustained traumatic mechanisms. Perinatal outcomes were compared with National Inpatient Sample (NIS) averages. Subset analysis of trauma patients without injury was performed. Multivariate regression highlighted independent predictors of adverse perinatal outcomes after trauma. Results: A total of 537 mother–fetus pairs were collected. Patients who sustained a traumatic mechanism at any gestational age during pregnancy had poorer perinatal outcomes, including preterm labor (odds ratio [OR] 1.40), placental abruption (OR 3.55), neonatal intensive care unit admission (OR 2.75), and neonatal demise (OR 1.71) compared to national averages ( P <.001). This held true regardless of whether injury was sustained. Logistic regression demonstrated an independent association between adverse perinatal outcomes and maternal injury severity score (ISS) (OR 1.13 per ISS unit, P =.016), earlier gestational age of pregnancy at the time of trauma (OR 1.03 per day before term, P =.010), and lower maternal age (OR 0.96 per year). CONCLUSIONS/IMPLICATIONS: In this retrospective analysis, adverse perinatal outcomes correlate with injury severity and with earlier gestational age. However, even in the absence of acute injuries, patients who underwent trauma evaluation during pregnancy had significantly poorer perinatal outcomes compared to national averages. Trauma evaluation may independently represent a marker for high-risk pregnancy, warranting closer monitoring.