Hidden Epidemic of Maternal, Fetal, and Neonatal Mortality and Injury from Crashes

Abstract

From 1975 to 2001, the average annual number of vehicle miles driven by women of reproductive age increased from 3,721 to 8,258. This increase resulted from a combination of factors, including increased employment, population growth, urban sprawl, inadequate mass transportation, and rising affluence. Unfortunately, this boost in motor vehicle use among young women has had a major unintended consequence: it has led to a substantial increase in maternal and fetal exposure to the violence of motor vehicle crashes. Tragically, along with the higher levels of exposure of pregnant women to motor vehicle crashes have come the increasingly better understood impacts of pregnancy-related crash-associated deaths, injuries, and other adverse outcomes on pregnant women, fetuses, and infants. From a mortality perspective alone, it has been estimated that the rate of fetal deaths due to motor vehicle crashes now exceeds the rate of infant deaths due to motor vehicle crashes by a factor of 7. Yet, despite the documented risks and concerns from empirical studies, few crash and injury data systems accurately track and capture the magnitudes and trends of these events and their outcomes. This paper focuses on (a) societal changes that have led to the problem, (b) deficiencies in crash and transportation data systems that have led to its neglect, (c) the magnitude of the problem and the nature of related adverse fetal outcomes derived from recent research, and (d) steps that need to be taken to improve the tracking of pregnancy-related crashes so that they become more visible and a higher priority for transportation research and safety.