Unveiling the impact of trauma during pregnancy.

BACKGROUND

Pregnant trauma patients present unique challenges in terms of assessment and management. This study assesses the impact of traumatic injuries on pregnant patients using a national trauma database.

METHODS

ACS-TQIP (2020-2021) identified traumatically injured females aged ≥15 and ​≤ ​55. Propensity score matching compared pregnant and not-pregnant patients. Primary outcome was mortality, with secondary outcomes including length of stay (LOS), emergency department and discharge disposition, interventions, and complications.

RESULTS

Of 947,000 traumatically injured females, 8421 (0.9 ​%) were pregnant. Pregnant patients (6.0 ​%) sustained firearm injuries more than not-pregnant patients (5.4 ​%) (p ​= ​0.02). Pregnant patients had more severe thoracic (47.2%vs.9.4 ​%) and abdominal injuries (7.1%vs.4.8 ​%) compared to not-pregnant patients (p ​< ​0.001). Among pregnant patients, 5.6 ​% had preterm labor, 2.6 ​% had cesarean sections, and 1.9 ​% had abortions. After matching, there was no significant difference in mortality between both groups (p ​= ​0.40). Pregnant patients had longer ICU LOS (p ​< ​0.05) and higher rates of unplanned return to ICU (p ​< ​0.05).

CONCLUSIONS

Pregnant patients are more often victims of firearm violence, sustaining critical thoracic and abdominal injuries. These injuries demand increased interventions, introduce complications, and can be fatal.