Association between maternally perceived quality and pattern of fetal movements and late stillbirth

Abstract

We investigated fetal movement quality and pattern and association with late stillbirth in this multicentre case-control study. Cases (n = 164) had experienced a non-anomalous singleton late stillbirth. Controls (n = 569) were at a similar gestation with non-anomalous singleton ongoing pregnancy. Data on perceived fetal movements were collected via interviewer-administered questionnaire. We compared categorical fetal movement variables between cases and controls using multivariable logistic regression, adjusting for possible confounders. In multivariable analysis, maternal perception of the following fetal movement variables was associated with decreased risk of late stillbirth; multiple instances of ‘more vigorous than usual’ fetal movement (aOR 0.52, 95% CI 0.32–0.82), daily perception of fetal hiccups (aOR 0.28, 95%CI 0.15–0.52), and perception of increased length of fetal movement clusters or ‘busy times’ (aOR 0.23, 95%CI 0.11–0.47). Conversely, the following maternally perceived fetal movement variables were associated with increased risk of late stillbirth; decreased frequency of fetal movements (aOR 2.29, 95%CI 1.31–4.0), and perception of ‘quiet or light’ fetal movement in the evening (aOR 3.82, 95%CI 1.57–9.31). In conclusion, women with stillbirth were more likely than controls to have experienced alterations in fetal movement, including decreased strength, frequency and in particular a fetus that was ‘quiet’ in the evening.

Reduced Fetal Movements and Perinatal Mortality

“…Bradford et al ( 31 ) examined the association between fetal movements’ quality and pattern to late stillbirth in a case-control study. They concluded that changes in the fetal movement pattern such as a decrease in the strength and frequency of fetal movements and a fetal calmness during the night hours were more likely to be experienced from women with stillbirths ( 31 ).…”

Assessing fetal movements in pregnancy: A qualitative evidence synthesis of women’s views, perspectives and experiences

“…Fetal movements (FMs) in pregnancy have long been used as an indicator of fetal wellbeing. A reduction in or absence of FMs may indicate fetal compromise or death [ 1 , 2 ]. The prevalence of women presenting with reduced FMs in pregnancy ranges from 4 to 23% across studies [ 3 – 5 ], with up to 55% of women experiencing a reduction in FMs in the days preceding an intrauterine death [ 6 ].…”

Fetal Movement Counting Using Optical Fibre Sensors

“…In another case-control study, it was found that women who reported increased strength of movements in the last 2 weeks had decreased risk of late stillbirth compared with those whose movements were unchanged [ 4 ]. Women who perceived their fetus to be quiet in the evening have an almost four-fold increased odds of late stillbirth [ 5 ]. Reduction of fetal movement also correlates with fetal hypoxia, fetal growth restriction, umbilical cord complications, being small for gestational age and long-term neurodevelopmental impairment [ 5 , 6 , 7 , 8 , 9 ].…”

“…Women who perceived their fetus to be quiet in the evening have an almost four-fold increased odds of late stillbirth [ 5 ]. Reduction of fetal movement also correlates with fetal hypoxia, fetal growth restriction, umbilical cord complications, being small for gestational age and long-term neurodevelopmental impairment [ 5 , 6 , 7 , 8 , 9 ]. In addition to reduction of fetus movements, there is also a hypothesis that a sudden episode of excessive fetal activity indicates fetal compromise, for example, representing fetal seizures, which if it persists can lead to fetal death [ 10 ].…”