University of Groningen Stillbirths preceded by reduced fetal movements ...

University of Groningen

Stillbirths preceded by reduced fetal movements are more frequently associated with placental insufficiency ter Kuile, Madeleine; Erwich, Jan Jaap H. M.; Heazell, Alexander E. P.

Published in: Journal of Perinatal Medicine

DOI: 10.1515/jpm-2021-0103

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Publication date: 2022

Link to publication in University of Groningen/UMCG research database

Citation for published version (APA): ter Kuile, M., Erwich, J. J. H. M., & Heazell, A. E. P. (2022). Stillbirths preceded by reduced fetal movements are more frequently associated with placental insufficiency: a retrospective cohort study. Journal of Perinatal Medicine, 50(6), 668-677.

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J. Perinat. Med. 2021; aop

Madeleine ter Kuile, Jan Jaap H.M. Erwich and Alexander E.P. Heazell*

Stillbirths preceded by reduced fetal movements are more frequently associated with placental insufficiency: a retrospective cohort study

Received March 3, 2021; accepted June 25, 2021; published online July 15, 2021

Abstract

Objectives: Maternal report of reduced fetal movements (RFM) is a means of identifying fetal compromise in pregnancy. In live births RFM is associated with altered placental structure and function. Here, we explored associations between RFM, pregnancy characteristics, and the presence of placental abnormalities and fetal growth restriction (FGR) in cases of stillbirth. Methods: A retrospective cohort study was carried out in a single UK tertiary maternity unit. Cases were divided into three groups: 109 women reporting RFM, 33 women with absent fetal movements (AFM) and 159 who did not report RFM before the diagnosis of stillbirth. Univariate and multivariate logistic regression was used to determine associations between RFM/AFM, pregnancy characteristics, placental insufficiency and the classification of the stillbirth. Results: AFM or RFM were reported prior to diagnosis of stillbirth in 142 (47.2%) of cases. Pregnancies with RFM prior to diagnosis of stillbirth were independently associated with placental insufficiency (Odds Ratio (OR) 2.79, 95% Confidence Interval (CI) 1.84, 5.04) and were less frequently associated with maternal proteinuria (OR 0.16, 95% CI 0.07, 0.62) and previous pregnancy loss 5.8%.

incorporate into a logistic regression model. The normality of continuous data was checked both visually using histograms, and statistically using Kolmogorov?Smirnov test. Most variables were not normally distributed; thus the Mann Whitney U test was used for continuous variables. Categorical data were analysed using the Chi square test or Fisher's exact test. Statistical significance was set at a p-value ................
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