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Published on: January 12, 2018
Pregnancy outcomes following hospitalisation for a fall in Washington State from 1987 to 2004
1Harborview Injury Prevention and Research Center, Seattle, WA 98104, USA. mschiff@u.washington.edu
Objective:
To evaluate the risk of adverse maternal and perinatal outcomes among pregnant women hospitalised following falls.
Design:
A population-based retrospective cohort study.
Setting:
Washington State, USA.
Population:
Pregnant women with a fetal death or live birth certificate linked to the hospitalisation discharge data from 1987 to 2004.
Methods:
Pregnant women who experienced a fall (n = 693) were identified by the presence of an International Classification of Disease-9th Edition external causation code of E880 through E888 and were compared with a randomly chosen group of pregnant women (n = 2079) not experiencing a fall hospitalisation during pregnancy. Poisson regression analysis was used to estimate adjusted relative risks (RR) and 95% CI for associations between falls and pregnancy outcomes.
Main Outcome Measures:
Preterm labour and delivery, placental abruption, fetal distress, and fetal hypoxia.
Results:
This study found an incidence rate of 48.9 pregnant fall hospitalisations per 100 000 deliveries. The majority of the fall hospitalisations occurred in the third trimester (79.3%), with 11.3% in the second trimester and 9.4% in the first trimester. The majority of injuries due to falls were fractures (47.4%), especially of the lower extremity, followed by contusions (18.0%) and sprains (17.3%). Falls were associated with an increased risk of preterm labour (RR 4.4, 95% CI 3.4-5.7), placental abruption (RR 8.0, 95% CI 4.3-15.0), fetal distress (RR 2.1, 95% CI 1.6-2.8), and fetal hypoxia (RR 2.9, 95% CI 1.3-6.5).
Conclusion:
In light of the increased risk of adverse maternal and perinatal outcomes associated with major falls resulting in hospitalisation, careful maternal and fetal monitoring following a major fall is warranted.