Outcomes for advanced aged (35 and older) versus younger aged pregnant trauma patients: A multicenter study

Negaar Aryan; Areg Grigorian; Alexa N Lucas; Erika Tay-Lasso; Danielle C Zezoff; Nicole Fierro; Navpreet K Dhillon; Eric J Ley; Jennifer Smith; Alden Dahan; Arianne Johnson; William Ganske; Walter L Biffl; Dunya Bayat; Matthew Castelo; Diane Wintz; Kathryn B Schaffer; Dennis J Zheng; Areti Tillou; Raul Coimbra; Jarrett E Santorelli; Morgan Schellenberg; Kenji Inaba; Brent Emigh; Thomas K Duncan; Graal Diaz; Sigrid Burruss; Rahul Tuli; Jeffry Nahmias

doi:10.1016/j.amjsurg.2023.06.004

Outcomes for advanced aged (35 and older) versus younger aged pregnant trauma patients: A multicenter study

Am J Surg. 2023 Dec;226(6):798-802. doi: 10.1016/j.amjsurg.2023.06.004. Epub 2023 Jun 2.

Authors

Negaar Aryan¹, Areg Grigorian², Alexa N Lucas³, Erika Tay-Lasso⁴, Danielle C Zezoff⁵, Nicole Fierro⁶, Navpreet K Dhillon⁷, Eric J Ley⁸, Jennifer Smith⁹, Alden Dahan¹⁰, Arianne Johnson¹¹, William Ganske¹², Walter L Biffl¹³, Dunya Bayat¹⁴, Matthew Castelo¹⁵, Diane Wintz¹⁶, Kathryn B Schaffer¹⁷, Dennis J Zheng¹⁸, Areti Tillou¹⁹, Raul Coimbra²⁰, Jarrett E Santorelli²¹, Morgan Schellenberg²², Kenji Inaba²³, Brent Emigh²⁴, Thomas K Duncan²⁵, Graal Diaz²⁶, Sigrid Burruss²⁷, Rahul Tuli²⁸, Jeffry Nahmias²⁹

Affiliations

¹ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, California, USA. Electronic address: negaara@hs.uci.edu.
² University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, California, USA. Electronic address: agrigori@uci.edu.
³ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, California, USA. Electronic address: alexa.lucas.c@gmail.com.
⁴ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, California, USA. Electronic address: elasso@hs.uci.edu.
⁵ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, California, USA. Electronic address: dczezoff@uci.edu.
⁶ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: nicole.fierro@cshs.org.
⁷ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: navpreetkdhillon@gmail.com.
⁸ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: eric.ley@cshs.org.
⁹ Division of Trauma and Critical Care, Harbor-UCLA Hospital, Torrance, CA, USA. Electronic address: jsmith3@dhs.lacounty.gov.
¹⁰ University of California, Riverside School of Medicine, Riverside, CA, USA. Electronic address: alden.dahan@medsch.ucr.edu.
¹¹ Cottage Health Research Institute, Santa Barbara Cottage Hospital, Santa Barbara, CA, USA. Electronic address: a11johns@sbch.org.
¹² Cottage Health Research Institute, Santa Barbara Cottage Hospital, Santa Barbara, CA, USA. Electronic address: wganske@sbch.org.
¹³ Trauma and Acute Care Surgery, Scripps Memorial Hospital, La Jolla, CA, USA. Electronic address: biffl.walter@scrippshealth.org.
¹⁴ Trauma and Acute Care Surgery, Scripps Memorial Hospital, La Jolla, CA, USA. Electronic address: bayat.dunya@scrippshealth.org.
¹⁵ Trauma and Acute Care Surgery, Scripps Memorial Hospital, La Jolla, CA, USA. Electronic address: castelo.matthewryan@scrippshealth.org.
¹⁶ Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA. Electronic address: diane.wintzmd@sharp.com.
¹⁷ Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA. Electronic address: kathryn.schaffer@sharp.com.
¹⁸ Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. Electronic address: dzheng@mednet.ucla.edu.
¹⁹ Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. Electronic address: atillou@mednet.ucla.edu.
²⁰ Riverside University Health System Medical Center, Comparative Effectiveness and Clinical Outcomes Research Center - CECORC, CA, USA. Electronic address: raulcoimbra62@yahoo.com.
²¹ Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego School of Medicine, San Diego, CA, USA. Electronic address: jsantorelli@health.ucsd.edu.
²² Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA. Electronic address: morgan.schellenberg@med.usc.edu.
²³ Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA. Electronic address: kenji.inaba@med.usc.edu.
²⁴ Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA; Warren Alpert Medical School at Brown University, Department of Surgery, Division of Trauma, USA. Electronic address: brent_emigh@brown.edu.
²⁵ Department of Trauma, Ventura County Medical Center, Ventura, CA, USA. Electronic address: thomas.duncan@ventura.org.
²⁶ Department of Trauma, Ventura County Medical Center, Ventura, CA, USA. Electronic address: graal.diaz@ventura.org.
²⁷ Department of Trauma, Acute Care Surgery, Surgical Critical Care, Loma Linda Medical Center, Loma Linda, CA, USA. Electronic address: sburruss@llu.edu.
²⁸ Comparative Effectiveness and Clinical Outcomes Research Center - CECORC, University of California Riverside School of Medicine, CA, USA. Electronic address: rahul.tuli@medsch.ucr.edu.
²⁹ University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, California, USA. Electronic address: jnahmias@hs.uci.edu.

PMID: 37355376
DOI: 10.1016/j.amjsurg.2023.06.004

Abstract

Background: Effects of advanced maternal age (AMA) pregnancies (defined as ≥35 years) on pregnant trauma patients (PTPs) are unknown. This study compared AMA versus younger PTPs, hypothesizing AMA PTPs have increased risk of fetal delivery (FD).

Methods: A retrospective (2016-2021) multicenter study included all PTPs. Multivariable logistic regression was used to evaluate risk of FD after trauma.

Results: A total of 950 PTPs were included. Both cohorts had similar gestational age and injury severity scores. The AMA group had increased injuries to the pancreas, bladder, and stomach (p < 0.05). There was no difference in rate or associated risk of FD between cohorts (5.3% vs. 11.4%; OR 0.59, CI 0.19-1.88, p > 0.05).

Conclusion: Compared to their younger counterparts, some intra-abdominal injuries (pancreas, bladder, and stomach) were more common among AMA PTPs. However, there was no difference in rate or associated risk of FD in AMA PTPs, thus they do not require increased observation.

Keywords: Advanced maternal age; Fetal delivery; Pregnancy complication; Pregnant trauma.

Publication types

Multicenter Study

MeSH terms

Abdominal Injuries* / epidemiology
Female
Fetus
Gestational Age
Humans
Maternal Age
Pregnancy
Pregnancy Outcome
Retrospective Studies