SP6.12 - Do Pregnant Females Experiencing Physical Traumatic Injury have Different Mortality Outcomes Compared to Non-pregnant Females? A Systematic Review and Metanalysis Free

To collate and analyse literature capturing mortality rates in pregnant and non-pregnant individuals of childbearing age who experienced physical trauma. Additionally, to identify any statistically significant differences in interventions received.

Comprehensive searches of PubMed, MEDLINE, and grey literature were conducted using MeSH terms. Data extraction by two independent reviewers was followed by quality assessments using the Newcastle-Ottawa Scale. A random effects meta-analysis assessed the effect of pregnancy on mortality post-physical trauma, employing risk ratios (RR) and 95% confidence intervals. Publication bias was evaluated through linear regression, Eggers test, and funnel plots.

Twelve studies met eligibility criteria, yielding 1,113,376 pregnant and 18,185,789 non-pregnant females of childbearing age who experienced physical trauma. Low publication bias was observed. Pregnant females demonstrated a 35% mortality reduction vs. non-pregnant females (pooled RR: 0.65 [0.47-0.89], p=0.008), though significant heterogeneity existed across studies (I2 = 77%). A subgroup analysis focusing on mechanism of injury found the mortality reduction in pregnancy increased to 59% in motor vehicle accidents (pooled RR = 0.41 [0.32-0.52], p<0.001) with minimal study heterogeneity (I2 = 0%). Pregnant (vs. non-pregnant) females were less likely to be intubated (pooled RR = 0.69 [0.58, 0.81], p=<0.001, I2 = 9), but there were no other significant differences in the types of intervention received.

Pregnant females have a lower mortality risk from physical trauma than non-pregnant counterparts, particularly where the mechanism of injury is a motor vehicle accident. Additional research is warranted to elucidate the underlying factors contributing to this observed difference.