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Decreased fetal movements: Perinatal and long-term neurological outcomes

  • Author Footnotes
    1 Contributed equally.
    Omri Zamstein
    Correspondence
    Corresponding author at: Soroka University Medical Center POB 151, Beer-Sheva, IL, Israel.
    Footnotes
    1 Contributed equally.
    Affiliations
    The Obstetrics and Gynecology Division, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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  • Author Footnotes
    1 Contributed equally.
    Tamar Wainstock
    Footnotes
    1 Contributed equally.
    Affiliations
    The Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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  • Eyal Sheiner
    Affiliations
    The Obstetrics and Gynecology Division, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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  • Author Footnotes
    1 Contributed equally.

      Abstract

      Background

      While maternal perception of decreased fetal movements during advanced stages of pregnancy may be an indicator for adverse perinatal outcome, the long-term neurological outcome of offspring of affected pregnancies remains largely unknown.

      Objective

      To examine whether maternal complaint of decreased fetal movements is associated with adverse perinatal outcomes, and to assess the implications of decreased fetal movements on long-term neurological morbidity of the offspring.

      Study design

      A single center cohort analysis including deliveries between the years 1991–2014 was conducted. The association between decreased fetal movements and adverse perinatal outcome was evaluated using a general estimation equation (GEE) multivariable analyses. Incidence of hospitalizations (up to age 18 years) due to various neurological conditions was compared between offspring of affected pregnancies, and those who were not, using a Kaplan-Meyer survival curve. A Cox proportional hazards model was used to control for confounders.

      Results

      439 (0.18%) of 242,342 deliveries included in this study were accompanied by maternal complaint of decreased fetal movements. Perinatal outcome was comparable between the groups, with no cases of perinatal mortality observed among the exposed group. Total neurological-related hospitalization rate of the offspring, as well as hospitalizations due to movement disorders, were higher among the exposed group (Kaplan-Meyer log-rank test P < 0.05). This association between decreased fetal movements and increased long-term neurological hospitalization proved to be independent of potential confounders with an adjusted hazard ratio of 1.54 (95% CI 1.0–2.37).

      Conclusion

      Maternal complaint of decreased fetal movements does not predict adverse perinatal outcome but is associated with an elevated risk for long-term neurological morbidity of the offspring.

      Keywords

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