Context: Pregnant women are exempted from the current seatbelt legislation in Japan despite the fact that seatbelt use is essential to reduce the risk of fatalities for these women and their fetuses in car crashes. Objective: To examine factors that might influence seatbelt use during pregnancy. Methods: A cross sectional study, with data collected via an anonymous, self administered questionnaire at obstetric clinics in suburban areas of Japan. Altogether 880 pregnant women receiving prenatal care in July 2001 were recruited. The relative effects of factors that might influence seatbelt use during pregnancy were estimated using logistic regression analysis. Results: Almost 70%-80% of pregnant women were consistent seatbelt wearers before pregnancy but seatbelt compliance was reduced by about half at 20 weeks or more gestation. Only 20% had received information on maternal seatbelt use, with one third reporting that seatbelt use is beneficial during pregnancy. Those who perceived that maternal seatbelt use is beneficial tended to maintain use, but daily car users and those who knew that they were exempted from seatbelt legislation were more likely to reduce use. Conclusions: Knowledge of the legislative exemption for pregnant women, misunderstanding of the benefits, and daily car use contributed to the reduction in seatbelt use after pregnancy.M aternal deaths as a result of traumatic injuries are becoming more prominent owing to the reduction of maternal mortality from other causes. Among external causes of these deaths, car crashes dominate.1-4 They are also a leading cause of fetal deaths associated with maternal trauma.
5Seatbelt use is recommended for pregnant women because it reduces fatal risks for the women and their fetuses in car crashes.6-8 Studies outside of Japan suggest that seatbelt compliance increases during pregnancy.
10Reasons for not wearing seatbelts include discomfort, fear of harming the fetus, forgetfulness, or habitual non-use. Non-seatbelt wearers were less likely to have received information on maternal seatbelt use and tended to misunderstand its benefits.
11 12Seatbelt use during pregnancy has gone unnoticed in Japan because expectant mothers are exempted from seatbelt legislated requirements. 13 This policy is in contrast to many other industrialized countries. Alongside other factors known to be associated with low seatbelt compliance-for example, age (younger), education (lower), socioeconomic status (lower), seating location (passengers), and annual distance traveled (longer)-there is likely to be reduced use during pregnancy. [14][15][16][17][18][19] The relative effects of factors affecting seatbelt use at this time need to be estimated when planning effective seatbelt promotion aimed at expectant mothers.In this study we investigated seatbelt use among pregnant women as drivers and front seat passengers and estimated the effects of factors that might influence seatbelt use during pregnancy.
METHODSThe study site was Mito City, the capital of Ibaraki Prefecture and situated abo...