Abstract：
BACKGROUND: Adverse events in fetuses are well researched but studies on the follow-up health outcomes of infants exposed to maternal motor vehicle crashes (MVCs) during pregnancy have yielded inconsistent results. This study aimed to investigate the association of maternal exposure to MVCs during pregnancy with the risk of adverse neonatal outcomes.
METHODS: This population-based cohort study used data from birth notifications in Taiwan. A total of 19 277 offspring with maternal exposure to MVCs during pregnancy and 76 015 randomly selected comparison offspring without such exposure were selected. Neonatal adverse outcomes were identified from National Health Insurance medical claims data. Conditional logistic regression was used to estimate the unadjusted and adjusted odds ratios (aORs) of neonatal adverse outcomes.
RESULTS: Offspring exposed to maternal MVCs during pregnancy had a higher risk of birth defects (aOR, 1.21; 95% CI, 1.04-1.41) than offspring without such exposure. This positive association was sustained with exposure to an MVC during the first or second trimester. A dose-response relationship (P = 0.0023) was observed between the level of injury severity and the risk of birth defects.
CONCLUSIONS: In the early stages of pregnancy, maternal exposure to MVCs may entail a risk of birth defects in the offspring. The potential mechanisms for the associations of maternal exposure to MVCs with birth defects need further investigation.
METHODS: This population-based cohort study used data from birth notifications in Taiwan. A total of 19 277 offspring with maternal exposure to MVCs during pregnancy and 76 015 randomly selected comparison offspring without such exposure were selected. Neonatal adverse outcomes were identified from National Health Insurance medical claims data. Conditional logistic regression was used to estimate the unadjusted and adjusted odds ratios (aORs) of neonatal adverse outcomes.
RESULTS: Offspring exposed to maternal MVCs during pregnancy had a higher risk of birth defects (aOR, 1.21; 95% CI, 1.04-1.41) than offspring without such exposure. This positive association was sustained with exposure to an MVC during the first or second trimester. A dose-response relationship (P = 0.0023) was observed between the level of injury severity and the risk of birth defects.
CONCLUSIONS: In the early stages of pregnancy, maternal exposure to MVCs may entail a risk of birth defects in the offspring. The potential mechanisms for the associations of maternal exposure to MVCs with birth defects need further investigation.
摘要：
背景：对胎儿的不良事件进行了充分的研究，但对怀孕期间暴露于母亲机动车碰撞（MVCs）的婴儿的后续健康结果的研究得出了不一致的结果。本研究旨在探讨孕妇在怀孕期间接触MVCs与不良新生儿结局风险的关系。
方法：这项基于人群的队列研究使用了台湾出生通知的数据。总共选择了19.277个在怀孕期间母体暴露于MVCs的后代和76.015个随机选择的没有这种暴露的比较后代。根据国家健康保险医疗索赔数据确定新生儿不良结局。使用条件逻辑回归来估计新生儿不良结局的未调整和调整比值比（aOR）。
结果：在怀孕期间暴露于母体MVCs的后代有更高的出生缺陷风险（aOR，1.21；95%CI，1.04-1.41)比没有这种暴露的后代高。在妊娠早期或中期暴露于MVC时，这种正相关得以维持。在损伤严重程度和出生缺陷风险之间观察到剂量反应关系（P=0.0023）。
结论：在怀孕早期，母体接触MVCs可能会导致后代出现出生缺陷的风险.孕产妇接触MVCs与出生缺陷的潜在关联机制需要进一步研究。
方法：这项基于人群的队列研究使用了台湾出生通知的数据。总共选择了19.277个在怀孕期间母体暴露于MVCs的后代和76.015个随机选择的没有这种暴露的比较后代。根据国家健康保险医疗索赔数据确定新生儿不良结局。使用条件逻辑回归来估计新生儿不良结局的未调整和调整比值比（aOR）。
结果：在怀孕期间暴露于母体MVCs的后代有更高的出生缺陷风险（aOR，1.21；95%CI，1.04-1.41)比没有这种暴露的后代高。在妊娠早期或中期暴露于MVC时，这种正相关得以维持。在损伤严重程度和出生缺陷风险之间观察到剂量反应关系（P=0.0023）。
结论：在怀孕早期，母体接触MVCs可能会导致后代出现出生缺陷的风险.孕产妇接触MVCs与出生缺陷的潜在关联机制需要进一步研究。
