Information about fetal movements and stillbirth trends in Iowa: analysis of time series data

Research output: Contribution to journalArticlepeer-review


Objective - To investigate implementation of the Count the Kicks campaign in Iowa to increase maternal awareness of fetal movements and its association with stillbirth rates.

Design - Time series analysis

Setting - Iowa, Illinois, Minnesota and Missouri, USA.

Sample - Women giving birth between 2005-2018.

Methods - Data regarding campaign activity, including App uptake and distribution of information materials, and population-level data on stillbirth rates and potential confounding risk factors were obtained from publicly-available data for 2005-2018. Data were plotted over time and examined in relation to key implementation phases.

Main outcome measure - Stillbirth

Results – App users were largely centred on Iowa, and increased over time, although numbers were modest relative to the number of births. Only Iowa demonstrated a reduction in stillbirth (OR 0.96, 95% CI 0.96-1.00 per year, interaction between state and time p
Conclusion – There was a reduction in stillbirths in Iowa, where an information campaign about fetal movements was active, which was not present in neighbouring states. Large-scale intervention studies are needed to determine whether the temporal associations between App use and stillbirth are causally related.
Original languageEnglish
JournalBritish Journal of Obstetrics and Gynaecology
Publication statusAccepted/In press - 13 Feb 2023


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