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Weiss HB, Songer TJ, Fabio A. Fetal Deaths Related to Maternal Injury. JAMA. 2001;286(15):1863–1868. doi:https://doi.org/10.1001/jama.286.15.1863
Author Affiliations: Center for Injury Research and Control, Department of Neurosurgery (Drs Weiss and Fabio) and Graduate School of Public Health, University of Pittsburgh (Dr Songer), Pittsburgh, Pa.
Context Maternal and fetal trauma is an important cause of adverse fetal outcomes.
However, systematic exclusion from US injury surveillance programs of even
the most severe outcome, fetal/neonatal death, has led to a lack of understanding
about frequency, causes, and prevention.
Objective To determine the rate of traumatic fetal deaths reported in state fetal
death registries and the types of trauma and physiologic diagnoses associated
with these deaths.
Design and Setting Retrospective descriptive study of fetal death certificates from 1995
through 1997 obtained from 16 states, which accounted for 55% of US live births
and approximately 15 000 fetal death registrations per year.
Main Outcome Measure Rate of fetal injury deaths, based on fetal death certificates coded
with an underlying cause of death due to maternal injury at 20 weeks' gestation
or later, by cause.
Results During the 3-year study period, 240 traumatic fetal injury deaths were
identified (3.7 fetal deaths per 100 000 live births). Motor vehicle
crashes were the leading trauma mechanism (82% of cases; 2.3 fetal deaths
per 100 000 live births), followed by firearm injuries (6% of cases)
and falls (3% of cases). In 3 states, reported crash-related fetal deaths
exceeded that of crash-related infant deaths. Placental injury was mentioned
in 100 cases (42%) and maternal death was noted in 27 cases (11%). A peak
rate of 9.3 fetal deaths per 100 000 live births was observed among 15-
to 19-year-old women.
Conclusions Motor vehicle crashes are the leading cause of fetal deaths related
to maternal trauma. Improved tracking of traumatic fetal injury deaths is
important to stimulate and guide research and efforts to reduce the risks
to women and fetuses from injury during pregnancy.
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