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

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.