Car seatbelts in pregnancy: the practice and knowledge of pregnant women remain causes for concern

Abstract

ObjectiveDesign A structured questionnaire. Setting District hospital antenatal clinic.Participants Two hundred pregnant women attending for their routine mid-pregnancy anomaly scan. Main outcome measuresTo evaluate current knowledge and practice among pregnant women about the use of car restraint systems during pregnancy.The women were asked about seatbelt and airbag usage, source of information about restraint systems and the legal requirements and recommendations regarding car safety systems.One hundred fifty-nine women (80%) completed the questionnaire. Ninety-eight percent wore seatbelts in the front, 68% wore seatbelts in the back of a car, 48% correctly identified where to place the seatbelt and 37% had received information on seatbelt use while pregnant. The latter were more likely to correctly position their restraints than those who had received no information ( P = 0.03). Thirty-nine percent had an airbag system fitted and one woman had de-activated it. Fifty-eight percent were aware seatbelt use was a legal requirement for driver and passengers when fitted.Many pregnant women are ignorant of the correct usage of seatbelts, their positioning and legal requirements. This puts their own wellbeing, and that of the fetus, at risk. Women should receive written instructions and advice from well informed health professionals and be encouraged always to wear a correctly positioned seatbelt. Education increases compliance and correct usage. Results Conclusions INTRODUCTIONLavenne developed the seatbelt in France in 1903 for use in aeroplanes and it was adopted for use in motor racing. From this approach evolved the standard threepoint restraint fitted in automobiles today'. Accident investigation in a research work published by De Haven entitled 'Injuries and death by car collision' in the 1950s identified that in 25% of serious accidents, death was caused by ejection from the car'. Adoption of the threepoint seatbelt has decreased deaths from road traffic accidents by 45% and moderate to critical injuries by 50%2. It became a statutory requirement to use seatbelts in the UK in 1983 in the front seats, and rear seats in 1991. The Department of Transport estimated that 200 lives and 7000 serious injuries a year are avoided by the compulsory use of seatbelts in front seats and that 100 deaths a year and 1000 major injuries are prevented when rear seatbelts are used in conjunction with front seat belts3. 644Trauma from motor accidents occurs in 2%-3% of pregnancies, 90% of which are of a minor nature. Fetal loss is reported as occurring in 1 %-3%46 and pregnancy outcome appears related to seatbelt use in a car accident7-12. In 1971, Crosby et al. reported that the major cause of fetal death in an accident was maternal death and this was significantly reduced by wearing a seatbelt. Fetal survival was improved if a three-point seatbelt rather than a lapbelt alone was ~o r n~, '~, '~.The American College of Obstetricians and Gynecologists issued guidelines on seatbelt usage for pregnant women in 199115. Subsequent ...

Seatbelt use by pregnant women: a survey of knowledge and practice in Hong Kong

“…in 40% to 50% of pregnant women. 5,6 Various other studies have shown reduced seatbelt compliance during pregnancy. 7 The proportion of seatbelt use has been reported to be around 70% to 80% before pregnancy, but reduced by half at 20 weeks or more of gestation.…”

“…5,7 There is also evidence that pregnant women lack information about the proper use of a seatbelt and its role in preventing injury: only 14% to 37% of pregnant women received advice from health care professionals. [5][6][7][8] The common reasons for not using a seatbelt have been reported to include discomfort, inconvenience, forgetfulness, and fear of harming the fetus. 9 In this study, the current practice and knowledge of Hong Kong pregnant women about seatbelt use was surveyed, and any determining factors were identified.…”

Correct Use of Three-Point Seatbelt by Pregnant Occupants

“…However, this did not clearly distinguish between the (incorrect) position 'lap belt across the upper thighs' and the correct position according to guidelines 'across the hips'. Therefore, it is not surprising that Arneson et al [14], Hammond et al [15], Johnson and Pring [11], and McGwin et al [18] reported a high incidence of correct lap belt positioning such as approximately 40-79%. In this study, the incorrect 'flat across the upper thighs' and correct 'across hips and under abdomen' data are classified into two separate groups in order to investigate the real correct use rate of the lap section.…”

Trauma in pregnancy

“…Motor vehicle accidents account for 60% of blunt traumas [1]. Pregnant women are less likely than other motorist to wear seatbelts because of concerns of fetal injury [35,36]. If they wear seatbelts they are often applied over the wrong site, potentially leading to increased fetal mortality [36].…”

“…Pregnant women are less likely than other motorist to wear seatbelts because of concerns of fetal injury [35,36]. If they wear seatbelts they are often applied over the wrong site, potentially leading to increased fetal mortality [36]. The ACOG and the RCOG have now produced speciWc guidelines reassuring pregnant women about the use of seatbelts reviewing the safety and beneWt of correctly applied three-point safety restraints [37,38].…”