Maternal and Fetal Outcomes in Pregnant Women with Burn Injuries: A Systematic Review and Meta-Analysis.
Juan Jose Parra Molina, Sergio Romero, Edgar Fabian Manrique Hernandez
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In 30 seconds
This systematic review and meta-analysis pooled maternal and fetal mortality in pregnant women with burn injuries, using observational studies and case series. Across 22 studies including 1162 women, pooled maternal mortality was 0.43 (95% CI, 0.36-0.50), and pooled fetal mortality was 0.57 (95% CI, 0.49-0.65). Both estimates showed substantial heterogeneity. Greater burn severity, particularly TBSA burned ≥50%, was consistently associated with worse outcomes. The authors rated the overall certainty of evidence as low and noted possible publication bias.
Key findings
- Pooled maternal mortality was 0.43 (95% CI, 0.36-0.50), with substantial heterogeneity (I2 = 72.9%).
- Pooled fetal mortality was 0.57 (95% CI, 0.49-0.65; I2 = 78.6%).
- Burn severity, particularly TBSA burned ≥50%, was consistently associated with worse maternal and fetal outcomes.
- Funnel plots suggested possible publication bias; overall certainty of evidence was low.
Why it matters
The pooled estimates indicate that burns during pregnancy can carry serious risks for both the pregnant patient and fetus, while the association with burn severity underscores the importance of assessing injury extent. However, substantial heterogeneity and low certainty mean these estimates should be interpreted cautiously and do not establish precise risks for an individual case.
What to keep in mind
The evidence was largely based on small observational studies and case series, with substantial heterogeneity, possible publication bias, and low overall certainty.