Pregnancy-associated injury hospitalizations in Pennsylvania, 1995

Study objective: To estimate the frequency of pregnancy-associated injury h ospitalization and compare rates between pregnant women and all women of re productive age by age, race, injury mechanism, intent, and other variables. Methods: Using International Classification of Diseases, Ninth Revision-Cli nical Modification (ICD-9-CM) selection criteria applied to Pennsylvania's 1995 acute hospital discharge data, all resident women ages 15 to 44 with c oexistent pregnancy and injury-related diagnoses were identified for descri ptive and comparative rate calculations. Results: Seven hundred sixty-one (4.6%) of the discharges to injured women of reproductive age were associated with pregnancy. The leading injury caus es among pregnant women were transportation-related (234 [33.6%]), falls (1 92 [26.4%]), poisonings (116 [16.0%]), and "struck by" (83 [11.4%]). Among all women 15 to 44 years, poisoning was the leading cause (32.6%) of injury , followed by transportation-related injuries (25.7%). The hospitalized inj ury incidence was 868 per 100,000 person-years for pregnant women versus 64 1 for all women ages 15 to 44 (rate ratio 1.35, 95% confidence interval [CI ] 1.25 to 1.45). Pregnant women were younger (median age 24.9 years versus 30.0 years), their mean length of stay was shorter (2.5 days versus 3.7 day s), the mean injury severity score was less (3.2 versus 4.8), and the media n charge per stay was lower ($4,164 versus $6,051). Rate ratios (pregnant v ersus all women in same age group) were significantly higher for younger wo men 15 to 19 years (rate ratio 2.69, 95% CI 2.49 to 3.14). Rate ratios were significantly higher for assaults (rate ratio 3.04, 95% CI 2.45 to 3.78), falls (rate ratio 2.33, 95% CI 2.01 to 2.70), motor vehicle occupant (rate ratio 2.0, 95% CI 1.73 to 2.31), and struck by (rate ratio 3.73, 95% CI 2.9 7 to 4.69). Rate ratios were lower far poisonings (rate ratio 0.71, 95% CI 0.59 to 0.86) and self-inflicted injuries (rate ratio 0.62, 95% CI 0.50 to 0.77). Conclusion: Pregnant women were more likely than all women 15 to 44 years t o be hospitalized for injury and more likely to be hospitalized for assault s, falls, transportation-related, and less severe injuries, but less likely for poisonings and self-inflicted injuries. Much of the increased risk app ears to be concentrated in young women. Further work is needed to establish to what extent the observed increases are the result of increased injury r ates or increased hospitalization rates.