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Maternal Perception of Fetal Activity and Late Stillbirth Risk: Findings from the Auckland Stillbirth Study

Authors

  • Tomasina Stacey RN, RM, MPH,

    1. Tomasina Stacey is a Doctoral Student in the Department of Obstetrics and Gynaecology, University of Auckland, and Lecturer in Midwifery, AUT University, Auckland; John Thompson is a Senior Research Fellow in Statistics/Epidemiology, Department of Paediatrics, University of Auckland; Edwin Mitchell is a Professor of Child Health in the Department of Paediatrics, University of Auckland; Alec Ekeroma is an Obstetrician and Gynaecologist in the Department of Obstetrics and Gynaecology, University of Auckland; Jane Zuccollo is a Senior Lecturer in Perinatal Pathology in the Department of Obstetrics and Gynaecology, Wellington Medical School, Wellington; and Lesley McCowan is a Professor of Obstetrics and Gynaecology/Head of Department, in the Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
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  • John M. D. Thompson PhD,

    1. Tomasina Stacey is a Doctoral Student in the Department of Obstetrics and Gynaecology, University of Auckland, and Lecturer in Midwifery, AUT University, Auckland; John Thompson is a Senior Research Fellow in Statistics/Epidemiology, Department of Paediatrics, University of Auckland; Edwin Mitchell is a Professor of Child Health in the Department of Paediatrics, University of Auckland; Alec Ekeroma is an Obstetrician and Gynaecologist in the Department of Obstetrics and Gynaecology, University of Auckland; Jane Zuccollo is a Senior Lecturer in Perinatal Pathology in the Department of Obstetrics and Gynaecology, Wellington Medical School, Wellington; and Lesley McCowan is a Professor of Obstetrics and Gynaecology/Head of Department, in the Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
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  • Edwin A. Mitchell FRSNZ, FRACP, DSc (Med),

    1. Tomasina Stacey is a Doctoral Student in the Department of Obstetrics and Gynaecology, University of Auckland, and Lecturer in Midwifery, AUT University, Auckland; John Thompson is a Senior Research Fellow in Statistics/Epidemiology, Department of Paediatrics, University of Auckland; Edwin Mitchell is a Professor of Child Health in the Department of Paediatrics, University of Auckland; Alec Ekeroma is an Obstetrician and Gynaecologist in the Department of Obstetrics and Gynaecology, University of Auckland; Jane Zuccollo is a Senior Lecturer in Perinatal Pathology in the Department of Obstetrics and Gynaecology, Wellington Medical School, Wellington; and Lesley McCowan is a Professor of Obstetrics and Gynaecology/Head of Department, in the Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
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  • Alec Ekeroma FRANZCOG, FRCOG, MBA,

    1. Tomasina Stacey is a Doctoral Student in the Department of Obstetrics and Gynaecology, University of Auckland, and Lecturer in Midwifery, AUT University, Auckland; John Thompson is a Senior Research Fellow in Statistics/Epidemiology, Department of Paediatrics, University of Auckland; Edwin Mitchell is a Professor of Child Health in the Department of Paediatrics, University of Auckland; Alec Ekeroma is an Obstetrician and Gynaecologist in the Department of Obstetrics and Gynaecology, University of Auckland; Jane Zuccollo is a Senior Lecturer in Perinatal Pathology in the Department of Obstetrics and Gynaecology, Wellington Medical School, Wellington; and Lesley McCowan is a Professor of Obstetrics and Gynaecology/Head of Department, in the Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
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  • Jane Zuccollo FRCPA,

    1. Tomasina Stacey is a Doctoral Student in the Department of Obstetrics and Gynaecology, University of Auckland, and Lecturer in Midwifery, AUT University, Auckland; John Thompson is a Senior Research Fellow in Statistics/Epidemiology, Department of Paediatrics, University of Auckland; Edwin Mitchell is a Professor of Child Health in the Department of Paediatrics, University of Auckland; Alec Ekeroma is an Obstetrician and Gynaecologist in the Department of Obstetrics and Gynaecology, University of Auckland; Jane Zuccollo is a Senior Lecturer in Perinatal Pathology in the Department of Obstetrics and Gynaecology, Wellington Medical School, Wellington; and Lesley McCowan is a Professor of Obstetrics and Gynaecology/Head of Department, in the Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
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  • Lesley M. E. McCowan FRANZCOG, MD, CMFM

    1. Tomasina Stacey is a Doctoral Student in the Department of Obstetrics and Gynaecology, University of Auckland, and Lecturer in Midwifery, AUT University, Auckland; John Thompson is a Senior Research Fellow in Statistics/Epidemiology, Department of Paediatrics, University of Auckland; Edwin Mitchell is a Professor of Child Health in the Department of Paediatrics, University of Auckland; Alec Ekeroma is an Obstetrician and Gynaecologist in the Department of Obstetrics and Gynaecology, University of Auckland; Jane Zuccollo is a Senior Lecturer in Perinatal Pathology in the Department of Obstetrics and Gynaecology, Wellington Medical School, Wellington; and Lesley McCowan is a Professor of Obstetrics and Gynaecology/Head of Department, in the Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
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  • This research was supported by Cure Kids; the Nurture Foundation for Reproductive Research; and Auckland District Health Board Trust Fund, Auckland, New Zealand.

Address correspondence to Tomasina Stacey, RN, RM, MPH, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.

Abstract

Abstract:  Background:  Maternal perception of decreased fetal movements has been associated with adverse pregnancy outcomes, including stillbirth. Little is known about other aspects of perceived fetal activity. The objective of this study was to explore the relationship between maternal perception of fetal activity and late stillbirth (≥ 28 wk gestation) risk.

Methods:  Participants were women with a singleton, late stillbirth without congenital abnormality, born between July 2006 and June 2009 in Auckland, New Zealand. Two control women with ongoing pregnancies were randomly selected at the same gestation at which the stillbirth occurred. Detailed demographic and fetal movement data were collected by way of interview in the first few weeks after the stillbirth, or at the equivalent gestation for control women.

Results:  A total of 155/215 (72%) women who experienced a stillbirth and 310/429 (72%) control group women consented to participate in the study. Maternal perception of increased strength and frequency of fetal movements, fetal hiccups, and frequent vigorous fetal activity were all associated with a reduced risk of late stillbirth. In contrast, perception of decreased strength of fetal movement was associated with a more than twofold increased risk of late stillbirth (aOR: 2.37; 95% CI: 1.29–4.35). A single episode of vigorous fetal activity was associated with an almost sevenfold increase in late stillbirth risk (aOR: 6.81; 95% CI: 3.01–15.41) compared with no unusually vigorous activity.

Conclusions:  Our study suggests that maternal perception of increasing fetal activity throughout the last 3 months of pregnancy is a sign of fetal well-being, whereas perception of reduced fetal movements is associated with increased risk of late stillbirth. (BIRTH 38:4 December 2011)

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