Injury: A Major Cause of Pregnancy-Associated Morbidity in Massachusetts
Hospital visits (inpatient, observation, and emergency department) for injury occurring during pregnancy and 1 year postpartum (the pregnancy-associated period) were examined to determine groups at risk for injuries. The dataset included maternally linked vital records and hospital visit data for a population-based cohort of women residing in Massachusetts who delivered between 2002 and 2003 (n = 100,051). Injury morbidity (injury visits with International Classification of Diseases, Ninth Revision, Clinical Modification codes 800–999.99 or selected E-codes) was evaluated by individual woman- and visit-based analyses. Overall, one in seven women sought hospital care for pregnancy-associated injuries, and rates were as high as one in four for some subgroups. Most pregnancy-associated injury visits (91%) occurred in emergency departments. More than 4% of women had a motor vehicle collision, which was the leading cause of injury. The risk for injury was significantly higher among women who were adolescents (relative risk [RR] = 1.88; 95% confidence interval [CI], 1.78–1.98), black non-Hispanic (RR = 1.88; 95% CI, 1.80–1.97), those who had public insurance (RR = 2.50; 95% CI, 2.41–2.56), or those who had less than a high school education (RR = 2.48; 95% CI, 2.39–2.58) when compared with referent groups. Clinical guidelines for preconception and pregnancy-associated periods should include recommendations for injury history assessment and preventative counseling for women.
© 2007 American College of Nurse-Midwives
Published in final form at:
Nannini A, Lazar J, Berg C, Tomashek K, Cabral H, Barger M, et al. Injury: a major cause of pregnancy-associated morbidity in Massachusetts. J Midwifery & Women’s Health 2008; 53(1): 3-10.I
Nannini, Angela; Lazar, Jane; Berg, Cynthia; Tomashek, Kay; Cabral, Howard; Barger, Mary; Barfield, Wanda; and Kotelchuck, Milton, "Injury: A Major Cause of Pregnancy-Associated Morbidity in Massachusetts" (2008). Nursing and Health Science Faculty Publications. 8.