TUESDAY, June 28, 2005 (HealthDay News) -- When the temperature goes up, so does the risk of serious injury for pregnant women, a new Canadian study has found.
The rate of hospitalizations for serious injuries among pregnant women is 12 percent higher during the months of May to October than during winter months, even surpassing the nine percent summertime trauma rate for the general population, reports lead researcher Dr. Donald A. Redelmeier, professor of medicine at the University of Toronto.
He speculated that "when it's dark and icy, people have their guard up and decide not to go out, but when the weather's nice, they have a false sense of security." This relative relaxation of attention could spur many of the motor vehicle accidents and falls that make up the bulk of trauma cases, he said.
Pregnant women "are not mountain climbing," he said, "but they are engaging in usual activities that don't [typically] get them into trouble, but are more problematic when they are pregnant," Redelmeier said.
An altered sense of balance, increased weight, loss of visual clues and the fact that it simply takes longer to get around all mean a woman should be more cautious in her daily activities. According to Redelmeier, this means allowing herself more time to get places, not using a cell phone in the car and making sure she has shoes that fit properly.
These findings are particularly important, he noted, because pregnancy complicates the treatment of traumatic injury. Doctors have to weigh the need for narcotic drugs, X-rays and surgical procedures against any potential harm to a mother and the fetus, Redelmeier explained.
"A splenectomy, for instance, is a fairly straightforward procedure, but even that is difficult when a woman is pregnant," he said.
And when women do suffer these injuries, he added, "there is an overlay of remorse -- 'If only I'd paid more attention to driving, this could have been avoided' -- that you don't see nearly as much in patients" with other conditions.
"Pregnant women take vitamins, exercise and watch their diets, but they don't give much thought to major trauma," he said. "Yet, many of these accidents can be avoided by engaging in customary activities in a mindful, unrushed manner."
For the study, Redelmeier and his colleagues reviewed data on all pregnancies in Canada between 1994-2001. In total, 2,618 pregnant women were admitted to hospitals for major trauma, ranging from broken bones to internal injuries. This represents about one in every thousand pregnancies during that period.
The hot months were marked by a spike in these injuries, with about 150 extra trauma admissions occurring in summer compared with the cooler seasons.
Most injuries were linked to common activities, indicating that pregnant women were certainly not engaging in high-risk activities such as extreme sports or heavy alcohol consumption. Nevertheless, the consequences of their injuries were substantial, with approximately 40 percent of patients requiring surgery and 10 percent staying in the hospital for more than a week.
The findings appear in the July issue of the Journal of Trauma.
Traumatic injury during pregnancy "is something that really has not gotten that much attention in the lay press, and it's an important issue," said Dr. Katherine Heilpern, associate professor and vice chair of the department of Emergency Medicine at Emory University School of Medicine.
Beyond the physical changes that affect pregnant women and make them more vulnerable to accidents, the fatigue that accompanies pregnancy and the stress of taking care of other children in the family can also take their toll, Heilpern said. Furthermore, "the risk of domestic violence is elevated during pregnancy," she said.
According to Heilpern, the care of an injured, pregnant woman is a highly emotional event for the patient, her partner and the emergency room staff, all of whom understand "that even a minor injury to a mother can be devastating to a fetus."
Redelmeier advises pregnant women to simply slow down and take care as they go about their daily tasks.
"When you're using the hedge trimmer, the Cuisinart, even bending over the dishwasher, take the time to pay attention to what you're doing as any number of traumatic events could be avoided by small changes in individual behavior. Prevention is the way to go," he said.
More information
For much more on a safe and healthy pregnancy, visit the American Academy of Family Physicians.
