Determinants of hospital utilization after maternal falls in southern NigeriaJacob Olumuyiwa Awoleke, Olusola Peter Aduloju, Babatunde Ajayi Olofinbiyi
Department of Obstetrics and Gynecology, Ekiti State University, Ado-Ekiti, Nigeria
International Medicine 2019; 1(6): 319-324 | DOI: 10.5455/im.57614 PDF
Background: Falls are the commonest cause of minor injuries during pregnancy. However, even apparently minor impact can be associated with serious obstetric complications, informing the need for hospital utilization. This study is designed to identify predictors of hospital utilization after maternal falls.
Methods: Using data from the inquiry into accidental maternal falls in Ado – Ekiti Local Government Area 2019 database, we compared hospital utilization and non-utilization after falls during pregnancy. The Abbreviated Injury Scale (AIS), an anatomical scoring system of the Association for the Advancement of Automotive Medicine, was employed to rank the injuries from the falls on a scale of 1 (minor) to 6 (unsurvivable).
Results: Hospital utilization rate was 27%; at least one-tenth of the injuries scored 3 or more on the AIS. Women who were married to professionals (30.7% versus 16.7%, p = 0.024) and had a family income in the highest quintile (12% versus 6.4%, p = 0.038) were more likely to seek medical care after a fall during pregnancy. Also, significantly more women visited the hospital when their injury was rated 4 (4% versus 2%, p = 0.001), especially when it involved the abdomen (22.7% versus 6.4%, p < 0.001). Logistic regression showed that ‘serious’ AIS score (adjusted odds ratio [AOR]: 7.42; 95% C.I. 2.71 – 20.34, p < 0.001), and abdominal involvement (AOR: 3.68; 95% C.I. 1.57 – 8.65, p = 0.003) independently predicted hospital utilization after maternal falls.
Conclusions: Provision of comprehensive and affordable healthcare, targeting women for pre-conceptional education to modify their perception about falls and providing information to pregnant women about care after falls could improve hospital utilization and reduce fall-related adverse pregnancy outcomes.
Keywords: abbreviated injury scale, accidental falls, emergency service, Nigeria, pregnancy