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Stillbirth is associated with perceived alterations in fetal activity - findings from an international case control study

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dc.contributor.authorHeazell, A.E.P.
dc.contributor.authorWarland, J.
dc.contributor.authorStacey, T.
dc.contributor.authorCoomarasamy, C.
dc.contributor.authorBudd, J.
dc.contributor.authorMitchell, E.A.
dc.contributor.authorO'Brien, L.M.
dc.date.issued2017
dc.description.abstractBackground: 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
dc.identifier.citationBMC Pregnancy and Childbirth, 2017; 17(1, article no. 369):1-11
dc.identifier.doi10.1186/s12884-017-1555-6
dc.identifier.issn1471-2393
dc.identifier.issn1471-2393
dc.identifier.orcidWarland, J. [0000-0002-9390-787X]
dc.identifier.urihttps://hdl.handle.net/11541.2/129601
dc.language.isoen
dc.publisherBioMed Central
dc.rightsCopyright 2017 The Author(s). (http://creativecommons.org/publicdomain/zero/1.0/) Access Condition Notes: Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made.
dc.source.urihttp://dx.doi.org/10.1186/s12884-017-1555-6
dc.subjectmaternal perception
dc.subjectfetal movement
dc.subjectreduced fetal movement
dc.subjectexaggerated fetal movement
dc.subjectstillbirth
dc.subjectHumans
dc.subjectPrenatal Care
dc.subjectLogistic Models
dc.subjectOdds Ratio
dc.subjectRisk Factors
dc.subjectCase-Control Studies
dc.subjectPerception
dc.subjectGestational Age
dc.subjectPregnancy
dc.subjectInternationality
dc.subjectAdult
dc.subjectPregnant Women
dc.subjectFemale
dc.subjectSurveys and Questionnaires
dc.titleStillbirth is associated with perceived alterations in fetal activity - findings from an international case control study
dc.typeJournal article
pubs.publication-statusPublished
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ror.mmsid9916166608701831

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