Interventions to increase maternal awareness of fetal movements no more effective than standard care.

Abstract

After an almost thirty year gap, there have been three large scale randomized trials investigating whether interventions to increase maternal and/or staff awareness of reduced fetal movements (RFM) reduces the stillbirth rate. Each study has employed different approaches; in the most recently reported study Flenady et al. report the outcome of a stepped-wedge cluster randomized controlled trial of a mobile phone based application (My Baby's Movements and Me) compared to standard care of a written brochure about fetal movements and a clinical practice guideline (Flenady et al. BJOG, 2021;TBC:TBC). The intervention did not significantly reduce the rate of stillbirth, but there was a significant reduction in the stillbirth rate over time from 2.7 to 2.0 per 1,000 births, on a background of a static stillbirth rate in Australia. Critically, there was not an increase in intervention rates or adverse short-term neonatal outcomes, with a possible reduction in the proportion of infants admitted to the neonatal intensive care unit.1.