Proper seatbelt use by pregnant women could prevent fetal deaths

A new study could have a profound effect on fetal deaths and injuries caused by car crashes.

Dr. Mark Pearlman instructs Juliet Fuller, of UMHS Public Relations, how to correctly use a seat belt when pregnant. U-M researchers say proper seat belt use saves lives of both women and their unborn children. (Photo by Scott Galvin, U-M Photo Services)

“It’s very clear, based on this study, that pregnant women should buckle up every single time they’re in a vehicle,” says senior author Dr. Mark Pearlman, vice-chair in the Department of Obstetrics and Gynecology at the U-M Health System. “Our study strongly suggests that about 200 fewer fetuses each year would die if women simply buckled up each time.” An estimated 370 fetuses die each year as a result of car crashes in the United States.

The research debunks a long-standing myth that wearing a seatbelt is not safe for pregnant women, says Pearlman, the S. Jan Behrman Professor of Reproductive Medicine.

“Some women are very concerned because they think the lap belt will injure their unborn baby in a crash. This study shows that the opposite is true, that seatbelts clearly protect the fetus, in large part because the fetus protects the mother,” he says. The study appears in the new issue of the American Journal of Obstetrics & Gynecology.

The study results have led Pearlman to initiate a campaign called Seatbelts Are For Everyone — Buckle All Babies In, or Safe Babi.

Pearlman teamed up with researchers from the U-M Transportation Research Institute (UMTRI), the Department of Emergency Medicine and the College of Engineering to study data from 57 automobile crashes involving pregnant women. The first-of-its-kind study performed detailed crash analysis, including accurate estimates of the crash severity and direction, maternal restraint usage and pregnancy outcome.

Among six crashes involving improperly restrained women, three (50 percent) resulted in fetal death or major fetal complications. Among crashes involving 10 women who were not using seatbelts, eight (80 percent) of the crashes resulted in fetal death or major complications. These numbers compare with fetal death or serious complications in 29 percent of crashes in which women were properly restrained by the seatbelt.

“Given that all cars in America have seatbelts, the potential benefits of these findings are significant,” says lead author Kathleen DeSantis Klinich, assistant research scientist with UMTRI.

The study states that:

• About 6-7 percent of women who are pregnant are involved in a car crash during their pregnancy. That translates to about 170,000 car crashes a year involving pregnant women;

• Pregnant women in car crashes resulting in serious fetal adverse outcomes are unbelted 62 percent of the time;

• There are more fetal deaths due to car crashes than there are deaths of children due to bicycle or car accidents in the first year of life; and

• The proper use of seatbelts by all pregnant women would prevent approximately 84 percent of serious adverse fetal outcomes (disabling injuries and deaths) due to car accidents.

In addition to Pearlman and Klinich, authors of the study are Carol Flannagan and Jonathan Rupp, both of UMTRI; Dr. Mark Sochor, of UMTRI and the Department of Emergency Medicine; and Lawrence Schneider, of UMTRI and the Department of Biomedical Engineering.


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