Increased fetal movements and neonatal outcomes of pregnancy interlinked ??

American Journal of Obstetrics and Gynecology, 2022 Reduced fetal movements are associated with several adverse neonatal outcomes, including stillbirth, fetal growth restriction, fetal distress, and preterm birth, little is known about maternal perceptions of increased fetal movement (IFM).

Several reports have suggested a single episode of IFM is a sign of an upcoming stillbirth. However, data regarding an association between IFM and neonatal outcomes are sparse.

Study in American Journal of Obstetrics and Gynecology aimed to evaluate characteristics and neonatal outcomes of pregnancies with perceived IFM, assuming it is a poor predictor of adverse neonatal outcomes.   

The retrospective cohort study included singleton pregnancies delivered in a tertiary referral hospital from 2014– 2020. Patients presenting to our obstetric triage with a single, isolated complaint of IFM >24w GA (IFM group) were compared to a control group of patients presenting for routine fetal assessment during pregnancy or labor, reporting regular fetal movements.

Patients presenting with reduced fetal movements during their pregnancies were excluded. The primary outcome was the severe composite adverse neonatal outcome of sepsis, respiratory distress/mechanical ventilation, cerebral injury, anemia/blood transfusion or intrapartum death.

The secondary outcome was the mild composite adverse outcome, including hypoglycemia, need for phototherapy, hypothermia, meconium aspiration syndrome, need for non-invasive ventilation, or umbilical cord pH<7.1.

A total of 43,714 women were in the study cohort, Induction of labor was more common in the IFM group (30.5% vs. 21.7%, p=0.001), as well as vacuum-assisted delivery (13.1% vs. 8.0%, p=0.001). 

No differences were found between groups in terms of the severe and mild composite adverse neonatal outcomes, as well as any other neonatal complication, including umbilical cord complications . No cases of stillbirth or intrapartum death were found in the IFM group.

Multivariable logistic regression found that IFM was a non significant risk-factor for composite adverse neonatal outcomes, labor induction and vacuum-assisted deliveries.

Researchers concluded that maternal perception of IFM does not seem to be associated with adverse neonatal outcomes or umbilical cord complications.

The perception of IFM is more common among nulliparous women. It might also be associated with greater awareness of fetal movements after sustaining abdominal trauma during the pregnancy. Placental location was not linked to IFM.