Risk of falls, fear of falling, and associated factors during pregnancy: a cross-sectional study

Abstract

Aim and objectives This research aims to determine women's risk of falls, fear of falling, and associated factors during pregnancy. Methods This community-based, cross-sectional study was conducted in T & uuml;rkiye between September 2023 and March 2024 to determine women's risk of falls, fear of falling, and associated factors during pregnancy. A total of 1,382 pregnant women aged 18 years and older were recruited using convenience and snowball sampling methods. In the first stage, pregnant women who met the eligibility criteria were invited to participate in the study from the researcher's personal network. An online survey link was shared with participants, and they were encouraged to forward the survey to other pregnant women in their networks. No restrictions were imposed based on gestational age (weeks). Data were collected using an intake form, the Pregnancy Falls Risk Assessment Scale (PFRAS), and the Modified Falls Efficacy Scale (MFES). Statistical analyses were performed using IBM SPSS Statistics version 25.0. Descriptive statistics, Spearman correlation, multivariable linear regression analyses were performed. Results A statistically significant, negative, and low level of correlation was determined between PFRAS scores and MFES scores (r = -0.165; p < 0.001). In addition, a statistically significant, positive, and weak relationship was determined between PFRAS scores and the number of pregnancies (r = 0.111; p < 0.001), weight gained during pregnancy (r = 0.242; p < 0.001) and body mass index values (r = 0.142; p < 0.001); and a statistically significant, negative, and weak relationship was determined between MFES scores and weight gained during pregnancy (r = -0.113; p < 0.001). In the regression analysis, unintended pregnancy (beta = 0.057, p < 0.05) and increased weight gain during pregnancy (beta = 0.202, p < 0.001) were associated with higher PFRAS scores, indicating a greater risk of falls. Conversely, the absence of a history of miscarriage or stillbirth (beta = -0.083, p < 0.05), the absence of a history of falls (beta=-0.085, p < 0.05), and higher MFES scores (beta = -0.127, p < 0.001) were associated with lower PFRAS scores. For MFES scores, extended family type (beta = -0.065, p < 0.05) and higher PFRAS scores (beta = -0.132, p < 0.001) were associated with lower MFES scores, reflecting decreased fall-related self-efficacy. In contrast, treatment-unaided conception (beta = 0.056, p < 0.05) was associated with higher MFES scores. Conclusions Determining and managing fall risks and fear of falling during pregnancy is essential for ensuring maternal safety. Nurses and midwives play a key role in identifying these risks, implementing preventive strategies, and raising women's awareness about fall prevention. It is recommended that systematic fall risk assessments be integrated into routine prenatal care to enable timely and individualized interventions, enhance maternal safety, and reduce healthcare burdens associated with fall-related complications.