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Maternal characteristics and pregnancy outcomes in women presenting with decreased fetal movements in late pregnancy

Authors

  • JULIE VICTORIA HOLM TVEIT,

    Corresponding author
    1. Division of Obstetrics and Gynecology, and Centre for Perinatal Research, Rikshospitalet University Hospital, and University of Oslo, Medical Faculty, Norway
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  • ELI SAASTAD,

    1. Norwegian Institute of Public Health, Division of Epidemiology, Oslo, Norway
    2. Akershus University College, Lillestrøm, and University of Oslo, Medical Faculty, Norway
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  • BABILL STRAY-PEDERSEN,

    1. Division of Obstetrics and Gynecology, and Centre for Perinatal Research, Rikshospitalet University Hospital, and University of Oslo, Medical Faculty, Norway
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  • PER E BØRDAHL,

    1. Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
    2. Institute for Clinical Medicine, Section for Gynaecology and Obstetrics, University of Bergen
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  • J FREDERIK FRØEN

    1. Norwegian Institute of Public Health, Division of Epidemiology, Oslo, Norway
    2. Brigham and Women's Hospital, Division of Maternal-Fetal Medicine, Harvard Medical School, Boston, MA
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Julie Victoria Holm Tveit, MD, Division of Obstetrics and Gynecology, Center for Perinatal Research, Rikshospitalet University Hospital, University of Oslo, Norway. Tel.: +47 23 07 02 26/+ 47 91 19 60 16. Fax: + 47 23 07 29 40. E-mail: julievh@medisin.uio.no

Abstract

Objective. ‘Normal’ fetal activity is recognized as a sign of fetal well-being and concerns for decreased fetal movements is a frequent cause of non-scheduled antenatal visits. The aim of this study was to identify maternal characteristics in women presenting decreased fetal movements in a total population, to identify the risk of adverse outcomes and assess the management provided. Design. Prospective population-based cohort. Setting. Fourteen delivery units in Norway. Population. A total of 2,374 pregnancies presenting with a perception of decreased fetal movements and 614 control/referent cases. Methods. All singleton third trimester pregnancies presenting with a perception of decreased fetal movements were registered from June 2004 through October 2005. Pregnancies never examined for this condition were collected as a cross-sectional sample from the same population. Main outcome measures. Fetal growth restriction, preterm birth and stillbirth. Results. Mothers with decreased fetal movements were more often smokers, overweight and primiparous. Of the women, 32% presented with perceived absence of fetal movements, of whom 25% waited for more than 24 hours without any movements. Abnormal findings were identified in 16% of examinations. Decreased fetal movements were associated with adverse pregnancy outcome in 26%, including preterm birth and fetal growth restriction. An intervention or repeated consultations were performed in 41% of cases, including 14% admissions to maternity ward. None of the included hospitals had written guidelines for management. Conclusions. A perception of decreased fetal movements is significantly associated with adverse pregnancy outcome such as preterm birth, fetal growth restriction and stillbirth. Guidelines for management and information to pregnant women are needed.

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