Pregnancy, birth and neonatal outcomes associated with reduced fetal
movements: A systematic review and meta-analysis of non-randomised
studies
Abstract
Background Several studies exploring the associations of
reduced fetal movements (RFM) with adverse perinatal outcomes have been
published in recent years. Objectives To synthesise the
evidence on pregnancy, birth and neonatal outcomes in women who
presented with RFM to ascertain associations between RFM and pregnancy
outcomes. Search Strategy PubMed, EMBASE, CINAHL complete,
Maternity and Infant Care, PsycINFO, and Science Citation Index
databases were searched from inception dates to 8th July 2021
Selection Criteria Non-randomised studies involving pregnant
women ≥24 weeks’ gestation, who presented with a primary complaint of
RFM compared to women who did not present with RFM were included.
Data Collection and Analysis Two authors independently
extracted data and assessed risk of bias using the Quality in Prognosis
studies (QUIPs) tool. Data were meta-analysed using a random-effects
model and presented as Odds Ratios (OR) or Standard Mean Differences
(SMD) with 95% Confidence Intervals (CI). Main Results
Thirty-nine studies were included. Women with RFM were more likely to
have a stillbirth (OR 3.44, 95% CI 2.02-5.88) and small for gestational
age (OR 1.36, 95% CI 1.15-1.61) when compared with women who did not
have RFM. Associations were also found for induction of labour,
instrumental birth and caesarean section but not for preterm birth (OR
0.92, 95% CI 0.71-1.19) or neonatal death (OR 0.99; 95% CI 0.51-1.91).
Conclusion RFM are associated with increased odds of stillbirth
and small for gestational age, induction of labour, instrumental birth
and caesarean section but not neonatal death.