From 1969 to 1990, annual motor-vehicle occupant miles driven by reproductive age women increased from 150 billion to over 400 billion. This increase has been fueled by population growth, urban sprawl, inadequate mass transportation, increased employment, and rising affluence. Unfortunately, this boost in motor-vehicle use among young women has also had a major unintended consequence: It has led to a substantial increase in maternal and fetal exposure to motor-vehicle crashes. Tragically, along with the much greater exposure of pregnant women to motor-vehicle crashes, has come the increasingly better understood impact of pregnancy-related crash-associated deaths, injuries and other adverse outcomes to pregnant women, fetuses and infants. From a mortality perspective alone, it has been estimated that the rate (in person-years) of fetal deaths due to motor vehicle crashes now exceeds the rate of infant deaths due to motor vehicles by a factor of seven. Yet, despite the documented risks and concerns, few crash and injury data systems accurately track and capture the magnitude and trends of these events and their outcomes. This paper focuses on: a) The historical factors leading to the problem, b) The specific 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 from epidemiologic 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.
Abstract