577 DECREASED FETAL ACTIVITY: A POSSIBLE INDICATION OF SUSCEPTIBILITY TO SIDS

Abstract

Over the past decade, obstetricians have begun to utilize maternal perception of fetal movements in utero as a measurement of fetal well-being. Some have speculated that fetal movements may be a qualitative measure of placental perfusion. Recent findings of brainstem gliosis in victims of Sudden Infant Death Syndrome (SIDS) and other indicators of deficient brainstem function have led Naeye and others to postulate that intrauterine hypoxemia may be an important prenatal factor in such children. The possible correlation between decreased fetal movements and intrauterine hypoxemia led us to question mothers of infants who died of SIDS, as well as mothers of infants with observed apnea and cyanosis, about the movements of their children prior to delivery. A significant decrease in fetal activity was recorded only if there was a total absence of activity for 24 consecutive hours or longer during the pregnancy. Forty percent (8/20) of SIDS victims were retrospectively recalled by their mothers to have decreased intrauterine activity. Similar questioning of mothers of “near miss” infants led to a 43% (59/137) response indicative of an absence of fetal activity for at least 24 hours. Clearly this represents a very significant minority of the SIDS population. A prospective study of infants exhibiting decreased fetal activity is being designed to test this hypothesis. Identification of such previously unrecognized “at risk” infants may be effective in helping to prevent SIDS deaths.