Fetal Movement Counting—Maternal Concern and Experiences: A Multicenter, Randomized, Controlled Trial

Authors

  • Eli Saastad CNM, MHSc,

    1. Eli Saastad is Assistant Professor at the Faculty of Health, Nutrition and Management at Akershus University College, Lillestrøm, and advisor at the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo; Brita A. Winje is a Doctoral Candidate at the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo; Pravin Israel is a Senior Researcher and a Clinical Psychologist at Akershus University Hospital, Lørenskog; and J. Frederik Frøen is the Director of the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway.
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  • Brita A. Winje RN, MPH,

    1. Eli Saastad is Assistant Professor at the Faculty of Health, Nutrition and Management at Akershus University College, Lillestrøm, and advisor at the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo; Brita A. Winje is a Doctoral Candidate at the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo; Pravin Israel is a Senior Researcher and a Clinical Psychologist at Akershus University Hospital, Lørenskog; and J. Frederik Frøen is the Director of the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway.
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  • Pravin Israel PhD,

    1. Eli Saastad is Assistant Professor at the Faculty of Health, Nutrition and Management at Akershus University College, Lillestrøm, and advisor at the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo; Brita A. Winje is a Doctoral Candidate at the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo; Pravin Israel is a Senior Researcher and a Clinical Psychologist at Akershus University Hospital, Lørenskog; and J. Frederik Frøen is the Director of the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway.
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  • J. Frederik Frøen MD, PhD

    1. Eli Saastad is Assistant Professor at the Faculty of Health, Nutrition and Management at Akershus University College, Lillestrøm, and advisor at the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo; Brita A. Winje is a Doctoral Candidate at the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo; Pravin Israel is a Senior Researcher and a Clinical Psychologist at Akershus University Hospital, Lørenskog; and J. Frederik Frøen is the Director of the Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway.
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  • This work has been supported by grants from the Norwegian SIDS and Stillbirth Society, Oslo, Norway.

Address correspondence to Eli Saastad, CNM, MHSc, Akershus University College, PB 423, N-2001 Lillestrøm, Norway.

Abstract

Abstract:  Background:  Fetal movement counting may improve timely identification of decreased fetal activity and thereby contribute to prevent adverse pregnancy outcomes, but it may also contribute to maternal concern. This study aimed to test whether fetal movement counting increased maternal concern.

Methods:  In a multicenter, controlled trial 1,013 women with a singleton pregnancy were randomly assigned either to perform daily fetal movement counting from pregnancy week 28 or to follow standard Norwegian antenatal care where fetal movement counting is not encouraged. The primary outcome was maternal concern, measured by the Cambridge Worry Scale. Analysis was by intention-to-treat.

Results:  The means and SDs on Cambridge Worry Scale scores were 0.77 (0.55) and 0.90 (0.62) for the intervention and the control groups, respectively, a mean difference between the groups of 0.14 (95% CI: 0.06–0.21, p < 0.001). Decreased fetal activity was of concern to 433 women once or more during pregnancy, 45 and 42 percent in the intervention and control groups, respectively (relative risk = 1.1, 95% CI: 0.9–1.2). Seventy-nine percent of the women responded favorably to the use of counting charts.

Conclusions:  Women who performed fetal movement counting in the third trimester reported less concern than those in the control group. The frequency of maternal report of concern about decreased fetal activity was similar between the groups. Most women considered the use of a counting chart to be positive. (BIRTH 39:1 March 2012)

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