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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Article info
Publication history
Published online: August 02, 2019
Accepted:
July 24,
2019
Received in revised form:
July 6,
2019
Received:
May 1,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
