The effect of air bags on pregnancy outcomes in Washington State: 2002-2005.

OBJECTIVE To estimate whether air-bag deployment is associated with an increased risk of adverse pregnancy outcomes. METHODS We performed a retrospective cohort study to assess the effect of air-bag availability and air-bag deployment on the risk of adverse pregnancy outcomes among pregnant, front-seat occupants in motor vehicle crashes in Washington State. Pregnant women involved in motor vehicle crashes were identified by linking birth and fetal death certificate data with Washington State Patrol crash data, which reported air-bag availability and deployment. We calculated relative risks (RRs) of adverse maternal and perinatal outcomes and 95% confidence intervals (CIs) using Poisson regression, adjusted for maternal age, seatbelt use, and vehicle model year. RESULTS We found no increased risk of adverse maternal or perinatal pregnancy outcomes among occupants of air-bag-equipped vehicles in all collisions (n=2,207) compared with those in vehicles without air bags (n=1,141). Among crashes in which air-bag deployment would be likely, we found a nonsignificant 70% increased risk of preterm labor (RR 1.7, 95% CI 0.9-3.2) and a nonsignificant threefold increased risk (RR 3.1, 95% CI 0.4-22.1) of fetal death among occupants in vehicles with air-bag deployment compared with occupants in vehicles without air bags, although fetal death results were limited by small numbers (2/198 [1.0%] in pregnant women whose air bags deployed; 2/622 [0.3%] in pregnant women whose air bags did not deploy). CONCLUSION Our findings provide clinicians with evidence to advise women that air bags do not seem to elevate risk of most potential adverse outcomes during pregnancy. LEVEL OF EVIDENCE II.