Association Between Hospital Trauma Designation and Maternal and Neonatal Outcomes after Injury among Pregnant Women in Washington State

Journal of the American College of Surgeons
John T DistelhorstMelissa A Schiff

Abstract

Approximately 8% of all pregnant women experience a traumatic injury during pregnancy. There has been no evaluation of a state trauma system's effect on birth outcomes. This study examined the association of treatment in a designated trauma hospital vs a nontrauma hospital on maternal and neonatal outcomes among injured pregnant patients in Washington State. We conducted a population-based retrospective cohort study (1995 to 2012). The Washington State Birth Events Records Database and the Comprehensive Hospital Abstract Recording System were linked to ascertain all hospitalized injured pregnant patients. The cohort was dichotomized by exposure to trauma vs nontrauma hospitals. We analyzed the association between trauma hospital designation and risk of adverse birth outcomes using logistic regression to estimate odds ratios and 95% CI, adjusting for Injury Severity Score and other confounders. We ascertained 3,429 injured pregnant women. Patients treated in trauma hospitals had an adjusted odds ratio (aOR) of 0.60 (95% CI, 0.50-0.73) for preterm labor, aOR = 0.74 (95% CI, 0.57-0.96) for gestational age <37 weeks, aOR = 0.72 (95% CI, 0.54-0.97) for birth weight <2,500 g, and aOR = 0.54 (95% CI, 0.39-0.76) for meconium at deliver...Continue Reading

References

Apr 4, 2003·JAMA : the Journal of the American Medical Association·Ellen J MacKenzieHarry Teter
Mar 5, 2004·Paediatric and Perinatal Epidemiology·Lisa M KorstJeffrey A Gornbein
Mar 5, 2005·American Journal of Epidemiology·Edward J BoykoBarbara Monsey
Jan 27, 2006·The New England Journal of Medicine·Ellen J MacKenzieDaniel O Scharfstein
Apr 4, 2006·American Journal of Obstetrics and Gynecology·Kenneth C Schoendorf, Amy M Branum
Oct 25, 2008·BJOG : an International Journal of Obstetrics and Gynaecology·M A Schiff
May 12, 2009·The Journal of Trauma·Michael T CudnikSteven M Steinberg
Jan 22, 2013·American Journal of Obstetrics and Gynecology·Hector Mendez-FigueroaDwight J Rouse
May 4, 2013·International Journal of Qualitative Studies on Health and Well-being·Alina HeringhausHelena Wigert

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Citations

Jul 9, 2016·Anaesthesia Critical Care & Pain Medicine·Mathias Rossignol
Sep 17, 2017·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·P PetroneC P Marini

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