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April 2, 2008

Proper seatbelt use by pregnant women would save 200 fetuses a year, University of Michigan study finds

Research leads to launch of effort called Safe Babi (Seatbelts Are For Everyone – Buckle All Babies In)

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

The study, by researchers at the University of Michigan, found that about 200 fetuses each year would not be lost if pregnant women properly used their seatbelts every time they were in an automobile.

“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 Mark D. Pearlman, M.D., 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 as a result of car crashes each year in the United States.

Mark D.  Pearlman, M.D., and Kathleen DeSantis Klinich, Ph.D.,

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 notes. 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 Safe Babi (Seatbelts Are For Everyone – Buckle All Babies In).

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 study, the first of its kind, 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 only 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, Ph.D., assistant research scientist with UMTRI.

The study states that:

  • About 6 to 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 accidents, or death of children due to car accidents in the first year of life.
  • 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.
  • If all women simply wore their seatbelts during pregnancy, ideally with the lap belt positioned under the pregnant abdomen, approximately 200 fetal lives would be saved. (This doesn't include the prevention of an unknown number of pre-term births and placental abruptions that result in brain injury and other long-term disabilities.)

Other published research by Pearlman shows that women whose prenatal care provider says anything at all about the importance of seatbelt use during prenatal visits are much more likely to wear their seatbelts (92 percent if the physician or nurse mentioned seatbelts versus 71 percent if they didn't), according to Pearlman. He encourages health care providers to remind all of their pregnant patients about the importance of using seatbelts.

In addition to Pearlman and Klinich, authors of the study are Carol A.C. Flannagan, Ph.D., and Jonathan D. Rupp, Ph.D., both of UMTRI; Mark Sochor, M.D., of UMTRI and the U-M Department of Emergency Medicine; and Lawrence W. Schneider, Ph.D., of UMTRI and the U-M College of Engineering’s Department of Biomedical Engineering.

Financial support for the initial research described in the paper was provided by General Motors, pursuant to an agreement between GM and the U.S. Department of Transportation. The UMTRI crash database is sponsored by the Alliance of Automobile Manufacturers. Additional data collection by the Crash Injury Research and Engineering Network program was sponsored by the National Highway Traffic Safety Administration.

Reference: American Journal of Obstetrics & Gynecology, Vol. 198, Issue 4, April 2008. “Fetal Outcome in Motor-Vehicle Crashes: Effects of Crash Characteristics and Maternal Restraint”

Written by: Katie Vloet

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