Fetal movement counting improved identification of fetal growth restriction and perinatal outcomes--a multi-centre, randomized, controlled trial.
BACKGROUND
Fetal movement counting is a method used by the mother to quantify her baby's movements, and may prevent adverse pregnancy outcome by a timely evaluation of fetal health when the woman reports decreased fetal movements. We aimed to assess effects of fetal movement counting on identification of fetal pathology and pregnancy outcome.


METHODS
In a multicentre, randomized, controlled trial, 1076 pregnant women with singleton pregnancies from an unselected population were assigned to either perform fetal movement counting from gestational week 28, or to receive standard antenatal care not including fetal movement counting (controls). Women were recruited from nine Norwegian hospitals during September 2007 through November 2009. Main outcome was a compound measure of fetal pathology and adverse pregnancy outcomes. Analysis was performed by intention-to-treat.


RESULTS
The frequency of the main outcome was equal in the groups; 63 of 433 (11.6%) in the intervention group, versus 53 of 532 (10.7%) in the control group [RR: 1.1 95% CI 0.7-1.5)]. The growth-restricted fetuses were more often identified prior to birth in the intervention group than in the control group; 20 of 23 fetuses (87.0%) versus 12 of 20 fetuses (60.0%), respectively, [RR: 1.5 (95% CI 1.0-2.1)]. In the intervention group two babies (0.4%) had Apgar scores <4 at 1 minute, versus 12 (2.3%) in the control group [RR: 0.2 (95% CI 0.04-0.7)]. The frequency of consultations for decreased fetal movement was 71 (13.1%) and 57 (10.7%) in the intervention and control groups, respectively [RR: 1.2 (95% CI 0.9-1.7)]. The frequency of interventions was similar in the groups.


CONCLUSIONS
Maternal ability to detect clinically important changes in fetal activity seemed to be improved by fetal movement counting; there was an increased identification of fetal growth restriction and improved perinatal outcome, without inducing more consultations or obstetric interventions.


BACKGROUND
ClinicalTrials.govNCT00513942.
Faculty of Health, Nutrition and Management, Oslo and Akershus University College of Applied Sciences, Oslo, Norway. eli.saastad@hioa.no
Eli
E
Saastad
Brita A
BA
Winje
Babill
B
Stray Pedersen
J Frederik
JF
Frøen
D000328:Adult; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D036861:Delivery, Obstetric; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D005324:Fetal Movement; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome