Sofa and bed-related pediatric trauma injuries treated in United States emergency departments

Injuries from falling out of bed in infants under 1 year of age: a systematic review

CONTEXT

Falls from beds are a leading cause of unintentional injuries in infants under 1 year of age. While most cases result in mild outcomes, the potential for severe injuries, such as skull fractures or intracranial haemorrhages, exists. Despite the prevalence of these incidents, no systematic review has focused specifically on injuries from bed falls in this specific age.

OBJECTIVE

To evaluate the risk and severity of injuries caused by falls from beds in infants under 1 year of age through a systematic review.

DATA SOURCES

We searched in PubMed, Embase, Cochrane Library and Lilacs Scielo for studies published between 1984 and December 2024.

STUDY SELECTION

We included observational studies that reported injuries from falls from beds in infants under 1 year.

DATA EXTRACTION

We extracted the relevant data from the included study details, recruitment setting, study design, sample size and outcome measures. We conducted a quality assessment using the Newcastle-Ottawa Scale.

RESULTS

Out of 297 initially identified studies, three met inclusion criteria, comprising a total of 2034 infants under 1 year of age. Most falls resulted in minor or no injuries. Warrington et al reported <1% of cases leading to concussion or fractures. Samuel et al identified two cases of intracranial haemorrhage and linear skull fractures without intervention. Kolulu et al observed significant injuries, including skull fractures and cerebral contusions, in 10.2% of infants.

CONCLUSIONS

Falls from beds are frequent in infants under 1 year, with most resulting in minor outcomes. However, serious injuries occur in around 5% of infants below 1-year old, emphasising the need for prevention strategies and clinical guidelines for managing post-fall assessments. Further research is required to refine understanding and improve prevention and management practices.

PROSPERO REGISTRATION NUMBER

CRD42024626255.

Exploring the Potential of a Behavior Theory-Informed Digital Intervention for Infant Fall Prevention: Mixed Methods Longitudinal Study

BACKGROUND

Falls are the most common hospitalized injury mechanism in children aged ≤1 years, and currently, there are no targeted prevention interventions. The prevention of falls in children of this age requires changes in the behavior of their caregivers, and theoretically informed digital behavior change interventions (DBCIs) may provide a unique mechanism for achieving effective intervention. However, user acceptance and the ability of DBCIs to effect the required changes in behavior are critical to their likelihood of success.

OBJECTIVE

This study aims to evaluate a behavior theory-informed digital intervention developed following a user-centered approach for user experience, the potential for this intervention to prevent infant falls, and its impact on behavioral drivers underpinning fall risk in young children.

METHODS

Parents of infants aged <1 year were recruited and asked to use the intervention for 3 months. A pre-post longitudinal design was used to examine the change in the potential to reduce the risk of falls after a 3-month exposure to the intervention. Postintervention data on behavioral drivers for fall prevention, user acceptability, and engagement with the app were also collected. Interviews were conducted to explore user experiences and identify areas for further improvement of the intervention.

RESULTS

A total of 62 parents participated in the study. A statistically significant effect on the potential to reduce falls was observed after the intervention. This effect was higher for new parents. Parents agreed that the intervention targeted most of the target behavior drivers. The impact of behavior drivers and intervention on the potential for fall prevention had a positive correlation. The intervention demonstrated good levels of acceptability. Feedback from participants was mostly positive, and the primary area identified for further improvement was widening the scope of the intervention.

CONCLUSIONS

This study demonstrated the promise of a newly developed digital intervention to reduce the risk of infant falls, particularly among new parents. It also showed a positive influence of the DBCI on the drivers of parental behaviors that are important for fall reduction among infants. The acceptability of the app was high, and important insights were gained from users about how to further improve the app.