Falls Under 6 Months of Age: 7-year Period at a Portuguese Hospital

Background: Falls are the third leading cause of death by unintentional injury in European Union children and represent an important cause of incapacity. There is lack of scientific research on the less-than-6-month-old group.

Objective: To describe epidemiologic characteristics, outcomes and factors related to a worse outcome of falls in a specific age group children.

Methods: Retrospective descriptive study of all infants younger than 6 months admitted to our Emergency Room (ER) because of unintentional fall. The study was conducted at a second level Portuguese hospital over a 7-year period (2012 through 2018).

Results: There were 112 ER admissions related with falls in this group (0,045% of all admissions).

Forty-eight percent had fallen from baby equipment. The majority (82,4%) occurred from a 50-100cm high and head trauma was present in 94,8%. Symptoms occurred in 23,2% of infants and head injury was the most common finding on medical examination (47,3%). Serious injuries were seen in 16,1%. Imaging abnormalities were identified in 7,1% (all with head fracture; one third with brain injury) and 6,3% required hospital admission or transference to another hospital.

Serious injury was more frequent in infants younger than 3 months (66,7% vs 33,3%, p=0,009), in those who had fallen from more than 76cm high (p=0,013) and when medical examination revealed alterations (72,2% vs 27,8%, p=0,032). Radiography with suspected skull fracture was significantly associated with fracture on computed tomography (p=0,033). No deaths or permanent sequelae were found.

Conclusion: In our study the most serious injuries occurred in infants younger than 3 months and from relatively small heights. Although present in almost 10%, fractures and brain injury didn’t have long term sequelae. It is important to reinforce the importance of preventive and supervision measures.