Trauma, firearms, and pregnancy: Beyond the cushion

Area of Science:

• Trauma surgery
• Obstetrics and Gynecology
• Emergency Medicine

Background:

• Pregnancy alters anatomy and physiology, potentially affecting injury susceptibility.
• A hypothesized
• cushion effect
• from anatomical changes may offer protection against penetrating trauma.
• This study investigates injury patterns and outcomes in pregnant trauma patients (PTPs).

Purpose of the Study:

• To compare injury patterns and clinical outcomes between PTPs and non-pregnant patients after penetrating trauma.
• To test the hypothesis that PTPs have reduced mortality and less severe abdominal injuries due to a protective
• cushion effect
• .

Main Methods:

• Utilized the 2020-2021 Trauma Quality Improvement Program database.
• Included female patients under 50 years old with penetrating trauma.
• Compared PTPs and non-pregnant patients using logistic regression analyses, focusing on mortality and injury incidence.

Main Results:

• PTPs (2.1%) had a higher prevalence of gunshot wounds (64.2% vs. 46.0%) and gastrointestinal injuries (8.5% vs. 6.3%).
• PTPs experienced more in-hospital cardiac arrests (2.1% vs. 1.0%) and showed a trend towards increased mortality (7.5% vs. 5.6%).
• The associated risk of death was similar between groups (OR = 1.08).

Conclusions:

• The study findings challenge the
• cushion effect
• hypothesis, as PTPs exhibited worse outcomes.
• Increased vulnerability to gastrointestinal injuries in PTPs may be due to gravid uterus spatial changes.
• Highlights the need for targeted primary prevention strategies for PTPs, especially concerning firearm violence.