To describe adverse birth outcomes associated with hospital-treated injuries that took place among women in the Danish National Birth Cohort.
Longitudinal cohort study.
90 452 women and their offspring selected from the Danish National Birth Cohort.
Primary and secondary outcome measures
To determine if injured women were more likely to deliver an infant preterm, with low birth weight, stillborn or have a spontaneous abortion, the authors estimated HRs. ORs were generated to assess APGAR scores and infants born small for gestational age (SGA). Models were adjusted for maternal smoking and drinking during pregnancy, household socioeconomic status, eclampsia/pre-eclampsia or gestational diabetes status during pregnancy and maternal age at birth; estimates for preterm birth were also adjusted for prior history of preterm birth.
In the cohort of 90 452 pregnant women, 3561 (3.9%) received medical treatment for an injury during pregnancy. Injured pregnant women were more likely to deliver infants that were stillborn or have pregnancies terminated by spontaneous abortion. The authors did not detect an adverse effect between injuries sustained during pregnancy and delivery of preterm, low birth weight or SGA infants, or infants with an APGAR score of <7.
The study shows that injuries occurring among women from an unselected population may not have an adverse effect on birth weight, gestational age, APGAR score or SGA status but may adversely affect the risk of stillbirth and spontaneous abortions in some situations.
We describe adverse birth outcomes associated with injuries that took place among pregnant women in the Danish National Birth Cohort and include in our assessment injury severity, cause and mechanism.
Injured pregnant women were more likely to deliver infants that were stillborn or have pregnancies that were terminated by spontaneous abortion. We did not detect an adverse effect between injuries sustained during pregnancy and delivery of preterm, low birth weight or SGA infants, or infants with an APGAR score of <7.
Women sustaining head or neck injuries were more likely to deliver an infant SGA and have a stillbirth, though these results were not statistically significant.
Strengths and limitations of this study
Previous studies have selected pregnant trauma patients or emergency room patients; our study, however, presents injuries among pregnant women from a general population.
We only have data on late spontaneous abortions, and if injured fetuses are aborted early, we would not detect an association.