American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 450.e1-450.e9 , April 2008

Fetal outcome in motor-vehicle crashes: effects of crash characteristics and maternal restraint

This research was presented at the 26th Annual Scientific Meeting of the American Gynecological and Obstetrical Society, Chicago, IL, Sept. 26-29, 2007.

  • Kathleen DeSantis Klinich, PhD

      Affiliations

    • University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI
  • ,
  • Carol A.C. Flannagan, PhD

      Affiliations

    • University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI
  • ,
  • Jonathan D. Rupp, PhD

      Affiliations

    • University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI
  • ,
  • Mark Sochor, MD

      Affiliations

    • University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI
    • Department of Emergency Medicine, University of Michigan Health Systems, Ann Arbor, MI
  • ,
  • Lawrence W. Schneider, PhD

      Affiliations

    • University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI
    • Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI
  • ,
  • Mark D. Pearlman, MD

      Affiliations

    • Departments of Obstetrics and Gynecology and Surgery, University of Michigan Health Systems, Ann Arbor, MI.

Received 18 April 2007 ,Revised 25 November 2007 ,Accepted 1 February 2008.

References 

  1. Weiss HB, Songer TJ, Fabio A. Fetal deaths related to maternal injury. JAMA. 2001;286(15):1863–1868
  2. Minino A, Heron M, Smith B. Deaths: preliminary data for 2004. Natl Vital Stat Rep. 2006;54(19):1–49
  3. Baethman M, Kahn T, Lenard H-G, Voit T. Fetal CNS damage after exposure to maternal trauma during pregnancy. Acta Paediatr. 1996;85(11):1331–1338
  4. Weyerts LK, Jones MC, James HE. Paraplegia and congenital contractures as a consequence of intrauterine trauma. Am J Med Gen. 1992;43(4):751–752
  5. Kettel LM, Branch DW, Scott JR. Occult placental abruption after maternal trauma. Obstet Gynecol. 1988;71(3 pt 2):449–453
  6. Pearlman M, Tintinalli JE, Lorenz RP. Blunt trauma during pregnancy. N Engl J Med. 1990;323:1609–1613
  7. Pepperell RJ, Rubinstein E, MacIsaac IA. Motor-car accidents during pregnancy. Med J Aust. 1977;1(7):203–205
  8. Lane PL. Traumatic fetal deaths. J Emerg Med. 1989;7(5):433–435
  9. Wolf ME, Alexander BH, Rivara FP, Hickok DE, Maier RV, Starzyk PM. A retrospective cohort study of seatbelt use and pregnancy outcome after a motor vehicle crash. J Trauma. 1993;34(1):116–119
  10. Hartl R, Ko K. In utero skull fracture: case report. J Trauma. 1996;41(3):549–552
  11. Van Enk A, Van Zwam W. Uterine rupture: a seat belt hazard. Acta Obstetr Gynecol Scand. 1994;73(5):432–433
  12. Pearlman M, Klinich K, Schneider LW, Rupp J, Moss S, Ashton-Miller J. A comprehensive program to improve safety for pregnant women and fetuses in motor vehicle crashes: a preliminary report. Am J Obstet Gynecol. 2000;182(6):1554–1564
  13. Pearlman M, Phillips ME. Safety belt use during pregnancy. Obstet Gynecol. 1996;88(6):1026–1029
  14. McGwin G, Russel SR, Rux RI, Leath CA, Valent F, Rue LW. Knowledge, beliefs, and practices concerning seat belt use during pregnancy. J Trauma. 2004;56(3):670–675
  15. McGwin G, Willey P, Ware A, Kohler C, Kirby T, Rue LW. A focused educational intervention can promote the proper application of seat belts during pregnancy. J Trauma. 2004;56(5):1016–1021
  16. WinSmash. Release 2.06x. Washington, DC: NASS; 1999;
  17. Baker SP, O’Neill B, Waddon W, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating care systems. J Trauma. 1974;14:186–187
  18. Weiss HB, Strotmeyer S. Characteristics of pregnant women in motor vehicle crashes. Inj Prev 8(3):207–10.
  19. Breslow NE. Statistics in epidemiology: the case-control study. J Am Stat Assoc. 1996;91(433):14–28
  20. Traffic Safety Facts 2005. Washington, DC: National Highway Traffic Safety Administration, NHTSA; 2005;Report No.: DOT HS 810 623
  21. Sims CJ, Boardman CH, Fuller SJ. Airbag deployment following a motor vehicle accident in pregnancy. Obstet Gynecol. 1996;88(4 pt 2):726
  22. Schultze PM, Stamm CA, Roger J. Placental abruption and fetal death with airbag deployment in a motor vehicle accident. Obstet Gynecol. 1998;92(4):719
  23. Robertson L. Further reflections on the seatbelt use and effectiveness issue. Inj Prev. 2003;9:284–285
  24. Traffic Safety Facts 1998. Washington, DC: National Highway Traffic Safety Administration, NHTSA; 1988;Report No.: DOT HS 808 983
  25. Thomas C, Henry C, Hartemann F, Patel A, Got C. Injury pattern and parameters to assess severity for occupants involved in car-to-car lateral impacts. In: Proceedings of the 11th International Conference for the Enhanced Safety of Vehicles. 1988;Washington, DC
  26. Dahmus MA, Sibai BM. Blunt abdominal trauma: are there any predictive factors for abruptio placentae or maternal-fetal distress?. Am J Obstet Gynecol. 1993;169(4):1054–1058
  27. Pearlman MD, Tintinalli JE, Lorenz RP. A prospective controlled study of outcome after trauma during pregnancy. Am J Obstet Gynecol. 1990;162:1502–1510
  28. Goodwin TM, Breen MT. Pregnancy outcome and fetomaternal hemorrhage after noncatastrophic trauma. Am J Obstet Gynecol. 1990;162(3):665–671
  29. Esposito TJ, Gens DR, Smith LG, Scorpio R, Buchman T. Trauma during pregnancy: a review of 79 cases. Arch Surg. 1991;126:1073–1078
  30. Hoff WS, D’Amelio LF, Tinkoff GK, Lucke JF, Rhodes M, Diamond DL. Maternal predictors of fetal demise in trauma during pregnancy. Surg Gynecol Obstet. 1991;172(3):175–180
  31. Rothenberger D, Quattlebaum FW, Perry JF, Zabel J, Fischer RP. Blunt maternal trauma: a review of 103 cases. J Trauma. 1978;18(3):173–179
  32. Viano DC. Restraint effectiveness, availability and use in fatal crashes: implications to injury control. J Trauma. 1995;38(4):538–546
  33. American College of Obstetricans and Gynecologists. Obstetric aspects of trauma management. ACOG Educational Bulletin. 1998;251
  34. Astarita DC, Feldman B. Seat belt placement resulting in uterine rupture. J Trauma. 1997;42(4):738–740
  35. Chetcuti P, Levene M. Seat belts: a potential hazard to the fetus. J Perinat Med. 1987;15(2):207–209
  36. Crosby WM, Costilow JP. Safety of lap-belt restraint for pregnant victims of automobile collisions. N Engl J Med. 1971;284:632–636

 The National Highway Transportation Safety Administration and the Alliance of Automobile Manufacturers provided support for the CIREN and UMTRI crash investigation programs, respectively.

 Cite this article as: Klinich KD, Flannagan CAC, Rupp JD, et al. Fetal outcome in motor-vehicle crashes: effects of crash characteristics and maternal restraint. Am J Obstet Gynecol 2008;198:450.e1-450.e9.

 Reprints not available from the authors.

PII: S0002-9378(08)00145-2

doi: 10.1016/j.ajog.2008.02.009

American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 450.e1-450.e9 , April 2008