Falls among pregnant women in Enugu, Southeast Nigeria

Olofinbiyi

The Scientific World Journal

et al. 2019

Falls during pregnancy can be associated with serious obstetric complications. Apart from sparse data highlighting traumatic outcomes, there are no studies identifying the obstetric correlates of maternal falls in Nigeria. A cross-sectional cohort survey of 1,175 women in five public health facilities in Ado–Ekiti was conducted to address this need. Fall rate was 25%; mothers who fell during pregnancy were significantly older, of higher parity, and with unintended/unwanted pregnancies than those who did not fall. Most of the reported falls occurred in the third trimester, with about 10% of the women falling at least thrice during the course of the pregnancy. More than half of the reported falls occurred while engaging in household chores and carrying child/object with compromised visibility of the feet and floor. Uterine contractions/abdominal pain was the commonest; 29 (76.3%), obstetric event attributed to the falls. Antepartum haemorrhage, 4 (10.5%), and ruptured membranes, 2 (5.3%), also occurred after falls, although it was rare and occurred with the same frequency as in the general population. Maternal age ≥ 30 years (odds ratio: 1.36; 95% C.I. 1.03 – 1.80, p = 0.031), multiparity (odds ratio: 1.54; 95% C.I. 1.15 – 2.07, p = 0.004), unintended pregnancy (odds ratio: 1.48; 95% C.I. 1.02 – 2.15, p = 0.037), and delivery age ≤ 40 weeks (odds ratio: 1.71; 95% C.I. 1.07 – 2.75, p = 0.026) were found to be independent risk factors for falls during pregnancy. Fall awareness campaigns and fall-preventing safety tips are advocated in women’s clinics. Improving contraceptive uptake will reduce unintended pregnancies and the risk of pregnancy-related fall/injuries.

Section: Discussioncontrasting

confidence: 75%

“…Significantly, multiparous women were more likely to fall during pregnancy from our survey. Although another study from southeast Nigeria concluded otherwise [21], the sample size was much smaller. Multiparous women were more likely to be involved in domestic duties as they care for their large families.…”

Section: Discussionmentioning

confidence: 99%

Obstetric Correlates of Maternal Falls in Southern Nigeria

Olofinbiyi

The Scientific World Journal

et al. 2019

“…Endometriosis is a common, although mysterious and fascinating, gynecological condition with diverse clinical manifestations and high variability. It has an unpredictable clinical course and results in diminished quality of life (Okeke et al, 2011). Despite extensive research, the pathogenesis of endometriosis remains unclear because it is complex.…”

Section: Discussionmentioning

confidence: 99%

Microarray analysis of microRNA deregulation and angiogenesis-related proteins in endometriosis

Teng

et al. 2016

Genet. Mol. Res.

ABSTRACT. We examined the aberrant microRNA (miRNA) expression profile responsible for the changes in angiogenesis observed in endometriotic lesions. This study revealed characteristic miRNA expression profiles associated with endometriosis in endometrial tissue and endometriotic lesions from the same patient, and their correlation with the most important angiogenic and fibrinolytic factors. miRNA expression was quantified using a microRNA array and reversetranscription microRNA polymerase chain reaction. Levels of vascular endothelial growth factor A (VEGFA), epidermal growth factor receptor 2 (EGFR2), phosphatase and tensin homolog (PTEN), and C-X-C chemokine receptor type 4 (CXCR4) were quantified using enzyme-linked immunosorbent assay. The endometrial tissue showed significantly lower levels of miR-200b, miR-15a-5p, miR-19b-1-5p, miR-146a-5p, and miR-200c, and higher levels of miR-16-5p, miR106b-5p, and miR-145-5p. VEGFA was significantly upregulated, whereas EGFR2, PTEN, and CXCR4 were markedly downregulated, in the endometriotic tissues compared to that in the normal endometrial tissues. In conclusion, differences in the miRNA levels could modulate the expression of VEGFA, EGFR2, PTEN, and CXCR4, and may play an important role in the pathogenesis of endometriosis. The higher angiogenic and proteolytic activities observed in the eutopic endometrium might facilitate the implantation of endometrial cells at ectopic sites.

“…The fall rate identified from this survey was 26%. This is inkeeping with the figures quoted by studies from south-eastern Nigeria (32.5%) [17], and other parts of the world [1,6,18]. Thus, it is clear that accidental maternal falls are issues of public health importance in Nigeria.…”

Section: Discussionmentioning

confidence: 76%

Untitled

2019

JPNBC

Accidental falls occur commonly during pregnancy. Evidence has shown that awareness and risk perception can influence prevention of health risks, including falls, during pregnancy. However, there are no fall risk assessment and prevention guidelines in Nigeria. A self-reported survey of 745 women from four public health facilities in Ado-Ekiti was employed to obtain information about knowledge and perception of maternal fall risk. Fall rate was 26%, and its occurrence was predicted by the women's perception of their risk of falling (adjusted odds ratio: 0.395; 95% C. I. 0.19-0.81; p = 0.017). The perception of the women about accidental maternal falls was significantly poorer amongst the women who were rural-dwellers (χ 2 = 10.26; p = 0.001), unskilled workers (χ 2 = 22.48; p < 0.001), had no more than a secondary education (χ 2 = 29.95; p < 0.001), and were in the lower-and middle-socioeconomic classes (III-V) (χ 2 = 24.22; p < 0.001). The women's knowledge of accidental falls during pregnancy was predicted by their occupation (χ 2 = 13.68; p = 0.03) and socioeconomic class (χ 2 = 20.38; p = 0.01). Fall awareness campaigns using effective risk communication models that can shape maternal perception of their fall risks should be promoted in women's clinics.