Background: Stillbirth after 28 weeks gestation affects between 1.3-8.8 per 1000 births in high-income countries. The majority of stillbirths in this setting occur in women without established risk factors. Identification of risk factors which could be identified and managed in pregnancy is a priority in stillbirth prevention research. This study aimed to evaluate women's experiences of fetal movements and how these relate to stillbirth. Methods: An international internet-based case-control study of women who had a stillbirth ≥28 weeks' gestation within 30 days prior to completing the survey (n = 153) and women with an ongoing pregnancy or a live born child (n = 480). The online questionnaire was developed with parent stakeholder organizations using a mixture of categorical and open-ended responses and Likert scales. Univariate and multiple logistic regression was used to determine crude (unadjusted) and adjusted odds ratios (aOR) with 95% confidence intervals (CI). Summative content analysis was used to analyse free text responses. Results: Women whose pregnancy ended in stillbirth were less likely to check fetal movements (aOR 0.54, 95% CI 0.35-0.83) and were less likely to be told to do so by a health professional (aOR 0.55, 95% CI 0.36-0.86). Pregnancies ending in stillbirth were more frequently associated with significant abnormalities in fetal movements in the preceding two weeks; this included a significant reduction in fetal activity (aOR 14.1, 95% CI 7.27-27.45) or sudden single episode of excessive fetal activity (aOR 4.30, 95% CI 2.25-8.24). Cases described their perception of changes in fetal activity differently to healthy controls e.g. vigorous activity was described as "frantic", "wild" or "crazy" compared to "powerful" or "strong". Conclusions: Alterations in fetal activity are associated with increased risk of stillbirth. Pregnant women should be educated about awareness of fetal activity and reporting abnormal activity to health professionals.
|Journal||BMC Pregnancy and Childbirth|
|Publication status||Published - 13 Nov 2017|
- Exaggerated fetal movement
- Fetal movement
- Maternal perception
- Reduced fetal movement
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Stillbirth is associated with perceived alterations in fetal activity – findings from an international case control study
Heazell, A. (Contributor), Warland, J. (Contributor), Stacey, T. (Contributor), Coomarasamy, C. (Contributor), Budd, J. (Contributor), Mitchell, E. A. (Contributor) & O'Brien, L. M. (Contributor), figshare , 13 Nov 2017
DOI: 10.6084/m9.figshare.c.3929200.v1, https://figshare.com/collections/Stillbirth_is_associated_with_perceived_alterations_in_fetal_activity_findings_from_an_international_case_control_study/3929200/1