@misc{10481/66459,
year = {2020},
url = {http://hdl.handle.net/10481/66459},
abstract = {Objectives To systematically review and quantify the
effect of motor vehicle crashes (MVCs) in pregnancy on
maternal and offspring outcomes.
Design Systematic review and meta-analysis of
observational data searched from inception until 1 July
2018. Searching was from June to August 2018 in
Medline, Embase, Web of Science, Scopus, Latin-American
and Caribbean System on Health Sciences Information,
Scientific Electronic Library Online, TRANSPORT,
International Road Research Documentation, European
Conference of Ministers of Transportation Databases,
Cochrane Database of Systematic Reviews and Cochrane
Central Register.
Participants Studies were selected if they focused on
the effects of exposure MVC during pregnancy versus
non-exposure, with follow-up to verify outcomes in
various settings, including secondary care, collision and
emergency, and inpatient care.
Data synthesis For incidence data, we calculated
a pooled estimate per 1000 women. For comparison
of outcomes between women involved and those not
involved in MVC, we calculated ORs with 95% CIs.
Where possible, we statistically pooled the data using
the random-effects model. The quality of studies used in
the comparative analysis was assessed with Newcastle–
Ottawa Scale.
Results We included 19 studies (3 222 066 women)
of which the majority was carried out in high-income
countries (18/19). In population-level studies of women
involved in MVC, maternal death occurred in 3.6 per 1000
(95% CI 0.25–10.42; 3 studies, 12 000 women; Tau=1.77),
and fetal death or stillbirth in 6.6 per 1000 (95% CI
3.81–10.12; 8 studies, 47 992 women; I2
=92.6%). Pooled
incidence of complications per 1000 women involved
in MVC was labour induction (276.43), preterm delivery
(191.90) and caesarean section (166.65). Compared with
women not involved in MVC, those involved had increased
odds of placental abruption (OR 1.43, 95%CI 1.27–1.63;
3 studies, 1 500 825 women) and maternal death (OR
202.27; 95%CI 110.60–369.95; 1 study, 1 094 559
women).
Conclusion Pregnant women involved in MVC were at
higher risk of maternal death and complications than those
not involved.},
publisher = {BMJ PUBLISHING GROUP},
title = {Maternal trauma due to motor vehicle crashes and pregnancy outcomes: a systematic review and meta-analysis},
doi = {10.1136/ bmjopen-2019-035562},
author = {Amezcua Prieto, María Del Carmen and Martínez Ruiz, Virginia Ana and Bueno Cavanillas, Aurora and Saeed Khan, Khalid},
}