Hospitalization of injured pregnant women: a decade of data

Pregnant women commonly sustain injuries following traffic collisions, falls, and intentional incidents such as domestic violence. Injuries sustained by pregnant women can lead to placental abruption, pelvic fracture, preterm delivery as well as maternal and fetal mortality. The aim of this study was to compare injury and hospitalization characteristics among hospitalized pregnant and nonpregnant women. For pregnant women, gestational age was analyzed according to injury severity and hospitalization characteristics.

The Israel National Trauma Registry was the data source for this retrospective study. Demographic, injury and hospitalization characteristics were collected and analyzed for pregnant and nonpregnant women hospitalized between Jan 1, 2012 and December 31, 2021. Among pregnant females, gestational age was identified. Categorical variables were compared using the Chi-square Test and Fisher's Exact Test.

A total of 33,377 women, aged 18-45 years, were hospitalized due to trauma-related injury; 14,606 (43.8%) were pregnant, and 18,771 (56.2%) were not pregnant. Among the pregnant women, 91.7% had an Injury Severity Score (ISS) of 1, and 75.9% were hospitalized for a single day. In comparison, 31% of the nonpregnant women had an ISS of 1 (P < 0.0001), and 32% were hospitalized for one day. Traffic accidents contributed to 51.8% of hospitalizations among pregnant women, compared with 42.8% among nonpregnant women. While falls were more prevalent among pregnant women, a greater proportion of nonpregnant women were hospitalized with intentional injuries. Among pregnant women, injuries during the third trimester are most common. However, those hospitalized during the first trimester suffered from more severe injuries than injuries during the second and third trimesters did. Compared with nonpregnant women, pregnant women are more likely to sustain minor injuries, have shorter hospitalization stays, have fewer surgical interventions and have fewer admissions to intensive care units (ICUs).

This study provides important data for medical personnel and policymakers regarding trauma-related injuries among pregnant women. The results highlight the need to reassess observation and treatment protocols to balance appropriate maternal and fetal care while minimizing unnecessary hospitalizations. Collaboration among policymakers, obstetricians, and neonatal specialists is essential to refining evidence-based protocols that improve outcomes for pregnant trauma patients and their fetuses.