Investigation And Study On The Current Situation And Risk Factors Of Falls In Pregnant Women In Different Pregnancy Periods

Objectives To investigate the situation of falls in early,middle and late pregnancy of pregnant women through longitudinal follow-up survey,to understand the current situation of falls,and to explore the main risk factors affecting the occurrence of falls in different pregnancy stages by combining quantitative and qualitative research,so as to provide scientific basis for formulating individualized falls prevention programs and taking active and effective preventive measures,so as to reduce the occurrence of falls in pregnancy.Rate,to ensure maternal and child safety.Methods This study was divided into two parts: quantitative research and qualitative research.Part I Quantitative study: Pregnant women in early pregnancy were selected from three medical institutions,Gansu People’s Hospital,940 Hospital of the People’s Liberation Army of China and Gansu Maternal and Child Health Hospital for the first maternity check-up.Since the first prenatal check-up(11-12 weeks of gestation),they were enrolled in the second trimester(27 weeks of gestation)and the third trimester(40 weeks of gestation)respectively.Follow-up was conducted with pregnant women in the early pregnancy survey.The survey was divided into five parts: demographic characteristics,prenatal examination,living and health status,indoor and outdoor environment,falls and injuries.The second part is qualitative research.By using phenomenological research methods in qualitative research,one-to-one in-depth interviews were conducted among pregnant women with a history of falls during pregnancy,and other potential risk factors of falls were further explored.Univariate analysis and multivariate logistic regression were used to analyze the risk factors of falls during different pregnancy stages.Result(1)Survey Number: A total of 1142 pregnant women in the early pregnancy were investigated;1108 pregnant women in the second trimester were followed up after excluding those who lost visits due to abortion,fetal malformation,transfer to other hospitals for obstetric examination,and did not cooperate with the investigation.The rate of lost visits was2.97%;1040 pregnant women in the late pregnancy were followed up after excluding those who could not continue to participate in the preterm birth and critical illness,and the rate of lost visits was 6.13%.The effective response rate was 91.07%.(2)The occurrence of falls in different pregnant periods: 186 pregnant women had falls in the early pregnancy,the incidence of which was about 16.28%.Nine of them had falls again,the incidence of falls again was about 4.83%.252 pregnant women had falls in the second trimester,the incidence of falls was about 22.74%.17 of them had falls again,and the incidence of falls again was about 6.75%.136 pregnant women had falls once and falls again in the third trimester.The incidence of falls was about 13.07%.There were no falls again in pregnant women.During the whole gestation period,the incidence of falls in the second trimester was the highest.(3)Falling during pregnancy will not only endanger the health of pregnant women and normal fetal development,but also increase the psychological burden of pregnant women and family financial burden.Pregnant women suffer more injuries from falls,including upper limbs and lower limbs.Epidermal abrasion,soft tissue injury,threatened abortion and premature delivery are common.Those with serious consequences are miscarriage,premature delivery and placental abruption.Individual pregnant women in the late pregnancy due to fallscaused fetal distress,placental abruption and emergency hospitalization,aggravating the psychological burden of pregnant women and family financial burden.(4)There are common risk factors for falls throughout pregnancy: age,height and environmental factors as common risk factors throughout the whole pregnancy.The incidence of falls in pregnant women under 30 years of age is higher than that in pregnant women over30 years of age;the incidence of falls in pregnant women over 1.65 m is higher than that in pregnant women below 1.65m;in the early and mid-trimester of pregnancy,outdoor falls are more than indoor falls,of which 68.81% and 58.73% are outdoor falls,31.19% and 41.27%are indoor falls,and outdoor falls are more common.In the third trimester of pregnancy,indoor falls were more than outdoor ones,of which 55.15% were pregnant women who fell indoors and 44.85% were pregnant women who fell outdoors.Indoor falls were more common in living rooms and toilets.(5)Specific risk factors for falls in pregnant women during different gestational periods: pregnancy response(OR=5.682,95%CI:3.438-9.392),anxiety(OR=2.092,95%CI:1.149-3.811),negligence(OR=5.428,95%CI:3.465-8.505),unaccompanied(OR=5.432,95%CI:3.083-9.573)were the specific risk factors for falls in early pregnancy.Pregnancy diabetes mellitus(OR=3.089,95% CI:1.570-6.079),anemia(OR=1.921,95%CI:1.075-3.434),balance ability(OR=1.965,95%CI:1.574-2.453),negligence(OR=4.805,95%CI:2.634-8.767),unaccompanied(OR=1.565,95%CI:1.033-2.371)are the specific risk factors for falling during the second trimester of pregnancy.Pregnancy diabetes mellitus(OR=2.582,95%CI:1.336-4.992),anemia(OR=2.489,95%CI:1.370-4.522),hypertension(OR=3.426,95%CI:1.772-6.623),ankle edema(OR=2.669,95%CI:1.671-4.262),balance ability(OR=1.404,95%CI:1.115-1.767)are the specific risk factors leading to fall in late pregnancy.(6)Education level and parity are protective factors for falls during pregnancy.Pregnant women with higher education level are less likely to fall than those with lower education level.The self-prevention consciousness of postpartum women is stronger,and the possibility of falling is lower than that of primipara.(7)Qualitative research results: There were 13 pregnant women interviewed.After Colaizzi’s 7-step analysis,the following four themes were extracted: prevention of falls and weak self-protection awareness,the phenomenon of "forgetting pregnancy" often occurs;emotional change tends to be negative,excessive worry about the outcome of childbirth;falls not only affect the safety of mothers and infants,but also cause a heavy financial burden;falls prevention experience and suggestions demand is high,pluralistic.There is a lack of cultural propaganda and education.Conclusion Falls are common in pregnant women during the whole gestation period,and the highest incidence is in the second trimester of pregnancy.Falling of pregnant women will not only cause serious physical injury and psychological trauma to pregnant women themselves,but also have adverse effects on the healthy development of the fetus.Falls of pregnant women are the result of a combination of multiple risk factors,and some of these risk factors run through the whole pregnancy,while the other part belongs to the specific risk factors of a certain stage of pregnancy.Therefore,on the basis of fully understanding the current situation and risk factors of falls during pregnancy,we should take active and effective measures to prevent falls and give multi-content and multi-form propaganda and education so as to enhance the self-prevention awareness of falls,effectively reduce the incidence of falls during pregnancy and ensure the safety of mothers and infants.