Pregnancy course and outcome following blunt trauma.

Objective: To investigate short- and long-term outcome following blunt trauma in pregnancy, and to identify risk factors for adverse pregnancy outcome in these cases.
Methods: A retrospective cohort study of all pregnant women who were admitted following blunt trauma (N=411). Women who experienced immediate complications (N=13) were compared with those who did not (N=398). Pregnancy outcome of women who experienced trauma during pregnancy and did not deliver during the trauma admission (N=303) were compared with a control group of women matched to by maternal age and parity in a 3:1 ratio (N=909).
Results: The overall rate of immediate complications was 3.2%, with the most common complications being preterm labor (2.0%) and placental abruption (1.7%). Independent risk factors for immediate complications were higher severity of trauma, multiple gestation, vaginal bleeding and uterine contractions at admission. Patients who experienced trauma were at increased risk for long-term adverse outcome including preterm labor, placental abruption, and perinatal morbidity. Increased trauma severity (ISS ≥ 5) and the need for laparotomy during the trauma hospitalization were independently associated with long-term adverse pregnancy outcome.
Conclusion: Trauma during pregnancy is associated with both immediate and long-term adverse pregnancy outcome. Women who experience trauma should be followed more closely throughout pregnancy.