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Original research
Maternal outcomes in association with motor vehicle crashes during pregnancy: a nationwide population-based retrospective study
  1. Ya-Hui Chang1,
  2. Yu-Wen Chien1,
  3. Chiung-Hsin Chang2,
  4. Ping-Ling Chen3,
  5. Tsung-Hsueh Lu1,
  6. I-Lin Hsu4,
  7. Chung-Yi Li1,5,6
  1. 1 Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  2. 2 Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  3. 3 Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
  4. 4 Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  5. 5 Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
  6. 6 Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
  1. Correspondence to Dr Chung-Yi Li, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; cyli99{at}mail.ncku.edu.tw

Abstract

Background Limited studies have assessed the association of motor vehicle crashes (MVCs) during pregnancy with adverse maternal outcomes using a population-based nationwide dataset that covers all MVCs.

Methods A total of 20 844 births from women who had been involved in MVCs during pregnancy were obtained from the National Birth Notification (BN) Database in Taiwan. We randomly selected 83 274 control births from women in the BN matched on age, gestational age and crash date. All study subjects were linked to medical claims and the Death Registry to identify the maternal outcomes after crashes. Conditional logistic regression models were used to estimate the adjusted odds ratio (aOR) and 95% CI of adverse outcomes associated with MVCs during pregnancy.

Results Pregnant women involved in MVCs had significantly higher risks of placental abruption (aOR=1.51, 95% CI 1.30 to 1.74), prolonged uterine contractions (aOR=1.31, 95% CI 1.11 to 1.53), antepartum haemorrhage (aOR=1.19, 95% CI 1.12 to 1.26) and caesarean delivery (aOR=1.05, 95% CI 1.02 to 1.09) than the controls. Such elevated risks tended to be higher in the MVCs with greater severity. Scooter riders had higher ORs of various adverse maternal outcomes than car drivers.

Conclusions Women involved in MVCs during pregnancy were at increased risk of various adverse maternal outcomes, especially in those with severe MVCs and riding scooters at MVCs. These findings suggest that clinicians should be aware of these effects, and educational materials that include the above information should be provided as part of prenatal care.

  • Mortality
  • Burden Of Disease
  • Exposure

Data availability statement

No data are available. Data management and all analyses were performed onsite at the Health and Welfare Data Science Center of the Taiwan Ministry of Health and Welfare. Data are not available to the public and data sharing is prohibited under the current government regulations.

https://doi.org/10.1136/ip-2022-044810

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    Data availability statement

    No data are available. Data management and all analyses were performed onsite at the Health and Welfare Data Science Center of the Taiwan Ministry of Health and Welfare. Data are not available to the public and data sharing is prohibited under the current government regulations.

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    Footnotes

    • IH and C-YL contributed equally.

    • Contributors Y-HC, Y-WC, C-HC, P-LC, T-HL, I-LH, and C-YL designed the study and contributed to the interpretation of the results. Y-WC, C-HC, and P-LC supervised the data management. T-HL and C-YL supported the resources. Y-HC, I-LH, and T-HL performed the statistical analyses. Y-HC drafted the initial manuscript. Y-WC, I-LH and C-YL revised the manuscript. C-YL is the guarantor of this work who accepts full responsibility for the work and the conduct of the study, had access to the data, and controlled the decision to publish. All authors approve the contents of the manuscript.

    • Funding This study was supported by a grant from the Ministry of Science and Technology (MOST 109–2314-B-006–044-MY3 and MOST 111–2917-I-006–002). The funder had no role in conducting and submitting this work.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.