Risk factors for poor neonatal outcome in pregnancies with decreased fetal movements

Sterpu, Irene; Pilo, Christina; Schuppe-Koistinen, Ina; Lindqvist, Pelle G.; Gemzell‐Danielsson, Kristina; Wiberg-Itzel, Eva

doi:10.1111/aogs.13827

Cited by 20 publications

(26 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the respondents reported there were factors affecting the implementation of guidelines, such as language barriers [41]. In a previous study of women seeking medical care for reduced foetal movements published by our research group in 2020, [42] it was found that in a very large percentage of stillbirths reduced foetal movement was the symptom of intrauterine death.…”

Section: Causes Of Deathmentioning

confidence: 99%

Could a multidisciplinary regional audit identify avoidable factors and delays that contribute to stillbirths? A retrospective cohort study

Sterpu

Bolk

Öberg

et al. 2020

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

Background The annual rate of stillbirth in Sweden has remained largely unchanged for the past 30 years. In Sweden, there is no national audit system for stillbirths. The aim of the study was to determine if a regional multidisciplinary audit could help in identifying avoidable factors and delays associated with stillbirths. Methods Population-based retrospective cohort study. Settings: Six labour wards in Stockholm County. Participants: Women delivering a stillbirth > 22 weeks of gestation in Stockholm during 2017. Intervention: A multidisciplinary team was convened. Each team member independently assessed the medical chart of each case of stillbirth regarding causes and preventability, level of delay, the standard of healthcare provided, the investigation of maternal/foetal diseases and if any recommendations were given for the next pregnancy. A decision was based on the agreement of all five members. If no agreement was reached, a reassessment of the case was done and the medical record was scrutinized again until a mutual decision was made. Primary outcomes: The frequency of probably/possibly preventable factors associated with a stillbirth and the level of delay (patient/caregiver). Secondary outcomes: The causes of death, the standard of antenatal/intrapartum/postpartum care, whether a summary of possible causes of the stillbirth was made and if any plans for future pregnancies were noted. Results Thirty percent of the stillbirths were assessed as probably/possibly preventable. More frequent ultrasound/clinical check-ups, earlier induction of labour and earlier interventions in line with current guidelines were identified as possibly preventable factors. A possibly preventable stillbirth was more common among non-Swedish-speaking women (p = 0.03). In 15% of the cases, a delay by the healthcare system was identified. Having multiple caregivers, absence of continuity in terms of attending the antenatal clinic and not following the basic monitoring program for antenatal care were also identified as risk factors for a delay. Conclusion A national/regional multidisciplinary audit group retrospectively identified factors associated with stillbirth. Access to good translation services or a more innovative approach to the problem regarding communication with mothers could be an important factor to decrease possible patient delays contributing to stillbirths. Trial registration NCT04281368.

show abstract

Section: Causes Of Deathmentioning

confidence: 99%

Could a multidisciplinary regional audit identify avoidable factors and delays that contribute to stillbirths? A retrospective cohort study

Sterpu

Bolk

Öberg

et al. 2020

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

show abstract

“…They also concluded that in this sample of women there was a higher frequency of low Apgar Score <7 at 5min: (3,3%), a higher frequency of low pH in umbilical cord blood (2,9%) and more babies had to be admitted in the NICU (3,9%). Additionally SGA fetuses had a significantly higher risk of stillbirth than normal fetuses ( 34 ).…”

Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

“…Sterpu et al, ( 34 ) performed a retrospective cohort study and investigated the outcome of 3243 pregnancies presenting with reduced fetal movements. They concluded that the risk of stillbirth in pregnancies with reduced fetal movements is five times higher than in normal pregnancies ( 34 ). They also concluded that in this sample of women there was a higher frequency of low Apgar Score <7 at 5min: (3,3%), a higher frequency of low pH in umbilical cord blood (2,9%) and more babies had to be admitted in the NICU (3,9%).…”

Section: Resultsmentioning

confidence: 99%

“…Management of pregnancies with RFM is a controversial side of this incidence. Six studies on ( Table 1 ) have found an association between reduced fetal movements and type of birth ( 34 , 35 , 37 , 38 , 40 , 41 ).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Reduced Fetal Movements and Perinatal Mortality

Bekiou¹,

Gourounti²

2020

Mater Sociomed

View full text Add to dashboard Cite

Evaluation of Pregnancy Outcomes Among Women With Decreased Fetal Movements

et al. 2021

View full text Add to dashboard Cite

IMPORTANCE Stillbirth is a devastating pregnancy outcome with far-reaching economic and psychosocial consequences, but despite significant investment, a screening tool for identifying those fetuses at risk for stillbirth remains elusive. Maternal reporting of decreased fetal movements (DFM) has been found to be associated with stillbirth and other adverse perinatal outcomes. OBJECTIVETo examine pregnancy outcomes of women presenting with DFM in the third trimester at a tertiary Australian center with a clear clinical management algorithm. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data on all births meeting the inclusion criteria from 2009 through 2019 at Mater Mothers' Hospital in Brisbane, Australia. This is a tertiary center and Australia's largest maternity hospital. All singleton births without a known congenital anomaly after 28 weeks' gestation were included. Among 203 071 potential participants identified from the hospital database, 101 597 individuals met the eligibility criteria. Data analysis was performed from May through September 2020. EXPOSURE Presentation to hospital with DFM after 28 weeks gestation. MAIN OUTCOMES AND MEASURES The primary outcome of this study was the incidence of stillbirth. Multivariate analysis was undertaken to determine the association between DFM and stillbirth, obstetric intervention, and other adverse outcomes, including being born small for gestational age (SGA) and a composite adverse perinatal outcome (at least 1 of the following: neonatal intensive care unit admission, severe acidosis [ie, umbilical artery pH <7.0 or base excess −12.0 mmol/L or less], 5-minute Apgar score <4, or stillbirth or neonatal death). The hypothesis being tested was formulated prior to data collection. RESULTS Among 101 597 women with pregnancies that met the inclusion criteria, 8821 (8.7%) presented at least once with DFM and 92 776 women (91.3%) did not present with DFM (ie, the control population). Women presenting with DFM, compared with those presenting without DFM, were younger (mean [SD] age, 30.4 [5.4] years vs 31.5 [5.2] years; P < .001), more likely to be nulliparous (4845 women [54.9%] vs 42 210 women [45.5%]; P < .001) and have a previous stillbirth (189 women [2.1%] vs 1156 women [1.2%]; P < .001), and less likely to have a previous cesarean delivery (1199 women [13.6%] vs 17 444 women [18.8%]; P < .001). During the study period, the stillbirth rate was 2.0 per 1000 births after 28 weeks' gestation. Presenting with DFM was not associated with higher odds of stillbirth (9 women [0.1%] vs 185 women [0.

show abstract

Risk factors for poor neonatal outcome in pregnancies with decreased fetal movements

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 20 publications

References 29 publications

Could a multidisciplinary regional audit identify avoidable factors and delays that contribute to stillbirths? A retrospective cohort study

Could a multidisciplinary regional audit identify avoidable factors and delays that contribute to stillbirths? A retrospective cohort study

Reduced Fetal Movements and Perinatal Mortality

Evaluation of Pregnancy Outcomes Among Women With Decreased Fetal Movements

Contact Info

Product

Resources

About