Pregnancy-associated injury hospitalizations: maternal and fetal outcomes

Background. Although injury is one of the leading causes of morbidity and mortality among reproductive-aged women, relatively little research has focused on pregnant women. The purpose of this study was to determine the incidence rate, causes, and outcomes of pregnancy-associated injury hospital- izations in Washington. Methods. A retrospective cohort design was used to evaluate women hospitalized for injury during pregnancy in Washington State from 1989 to 1997. Pregnant women hospitalized for injury were identified by linking Wash- ington state files containing birth and fetal death certificate data with hospital discharge data from all Washington state civilian hospitals, with injury defined as any ICD-9 injury diagnosis or external causation codes except poisonings and medical mis- adventures. These women were compared with a randomly chosen group of delivering women not experiencing an injury hospitalization during pregnancy. Pregnancy outcomes were evaluated using relative risks (RR) and 95% confidence intervals (95% CI). Results. The overall incidence of pregnancy- associated injury hospitalizations was 243.4/100 000 live births. Motor vehicle crashes (30.4%), falls (27.3%), and assaults (8.2%) were the most common causes of injuries. Pregnant women hos- pitalized for injury were at increased risk of placental abruption (RR 3.3, 95%CI 2.5-4.3), cesarean delivery (RR 1.2, 95%CI 1.1-1.3), and death (RR = 11.5, 95%CI 1.9-68.7) compared with non-injured pregnant women. Their infants were at increased risk of low birth weight (