Obstetric Correlates of Maternal Falls in Southern Nigeria

Abstract

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.

Risk factors for accidental falls during pregnancy – a systematic literature review

“…The study population is defined in Table 1. Four studies used questionnaires as a method for risk factor analysis [31,32,34,40], nine studies assessed postural sway and balance by posturography [25,33,[35][36][37][38][39] and one study performed kinematic analysis of torso kinematics and step width during gait [41].…”

“…Four studies included a questionnaire to assess the risk factors for falling during pregnancy [31,32,34,40]. In two of the studies, telephone and internet surveys were conducted.…”

“…The questionnaire was selfadministered. Awoleke and colleagues [40] formed a questionnaire based on other injury evaluation instruments from three other studies [31,42,43]. The questionnaire was self-administered.…”

“…Five studies identified different extrinsic factors that are associated with falls during pregnancy and performed a frequency analysis to measure the effect size [25,31,32,34,40]. The percentages of falls that occurred due to an extrinsic factor are presented in Table 2.…”

“…Proportions of falls that occurred due to an extrinsic risk factor. cause Dunning et al[31] (%) Dunning et al[32] (%) McCrory et al[25] (%) Okeke et al[34] (%) Awoeke et al[40] (%)…”