Evaluation of Pregnancy Outcomes Among Women With Decreased Fetal Movements

Jessica M Turner,Vicki Flenady,David Ellwood,Sailesh Kumar,Michael Coory

doi:10.1097/01.ogx.0000798448.64835.4d

Abstract

(Abstracted from JAMA Network Open 2021;4(4):e215071) Decreased fetal movement (DFM) has previously been associated with stillbirth and other adverse perinatal outcomes. Several guidelines highlight the importance of DFM as a sign associated with a risk of stillbirth; however, there is limited national guidance to incorporate this monitoring into stillbirth reduction strategies.

Highlights

Reducing the tragedy of the estimated 2 million deaths that occur in the antenatal and intrapartum period remains the focus of significant national and international[1] efforts
Presenting with decreased fetal movements (DFM) was not associated with higher odds of stillbirth (9 women [0.1%] vs 185 women [0.2%]; adjusted odds ratio [aOR], 0.54; 95% CI, 0.23-1.26, P = .16)
Presenting with DFM was associated with higher odds of planned early term birth, induction of

Summary

Introduction

Reducing the tragedy of the estimated 2 million deaths that occur in the antenatal and intrapartum period remains the focus of significant national and international[1] efforts. In low-income and middleincome countries, almost 1 in 2 stillbirths occurs during labor. In high-income countries, most stillbirths occur in the antenatal period,[2] potentially allowing time to mitigate this risk through lifestyle and behavior change, optimization of management of comorbidities, identification of fetuses who are small for gestational age (SGA),[3,4] and education regarding the importance of monitoring fetal movements. The causative pathways that culminate in fetal death are often poorly understood, making complete prevention of stillbirth problematic. Because of this difficulty, most stillbirth mitigation strategies involve a package of interventions addressing different elements of prenatal care, education, and risk factors.[5,6]. Maternal perception of fetal movements is highly subjective, and there is no universally agreed upon definition.[18]

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Discussion

Conclusion