Summary of Journal article:
This was a case control study done in New Zealand between 2012-2015 that included 733 participants (164 cases and 569 controls) that assessed maternal perception of fetal movement quality and relationship to late still birth. Cases were women who experienced a singleton late still birth (at > or = 28 weeks’ gestation) and were interviewed soon after still birth. Controls were women with ongoing singleton non-anomalous pregnancies. They stated that it is hypothesized that decrease FM may be a compensatory mechanism for placental insufficiency to allow for conservation of energy and may indicate fetal compromise. Perception of dec. fetal movement was believed to be associated with risk of still birth and other adverse outcomes like oligohydramnios, cord accident, etc. Still birth has been seen to be associated with higher maternal BMI, maternal age of > 40 years and SGA babies.
Data was obtained using a questionnaire administered by trained midwives.
They assessed maternal perception of fetal movement strength and frequency, fetal movement clusters (or busy times – group of movements which may be short or prolonged and involve many movements for up to 20 mins), and fetal movement in relation to diurnal rhythm, maternal position, and meals.
- For most of the cases fetal death was discovered during routine antennal visit
- They found that mothers that reported more instances of vigorous fetal movements more often, or daily perception of fetal hiccups (jerking movements every 1-2 second intervals over 1-2 mins) or increased length of fetal movements had lower risk of late still birth.
- Increases strength of fetal movement was associated with reduced odds of still birth
- Those that reported less frequency of fetal movement, or light fetal movements in the evening had increased odds of late still birth.
- Maternal perception of “fetal hiccups” was a found to be associated with reduced odds of still birth
- Busy times were associated with reduced odds of late still birth especially when longer than they previously were.
- Diurnal patterns: light movements in the late afternoon or evening was associated with increased odds of late still birth and vice versa.
The study further supports and showed the importance of maternal perception of fetal movements and how seeking early medical care could be beneficial to reducing the occurrence of still birth. They showed that findings such as decrease in strength of fetal movements and frequency, and less FM at evening time have been associated with still birth. Conversely, increased strength of fetal movements and frequency, vigorous movements multiple times a day, fetal hiccups and busy times of the same or increased length are positive features that indicate less risk of still birth.