Association between reduced fetal movements at term and first trimester markers of impaired placental development

Understanding the associations and significance of fetal movements in overweight or obese pregnant women: a systematic review

“… PRISMA flowchart. Twenty‐three publications were identified as eligible but two were from one study , and three were from another study . One publication that reported on presentation with decreased fetal movements was part of a larger cohort study .…”

“…O'Sullivan et al and Dutton et al found no association between BMI and risk of stillbirth, but these studies were not adequately powered to assess this outcome . Pagani et al reported that among women presenting with DFM, those with an SGA infant (birthweight <10th population centile) compared with appropriate for gestational age infant had a slightly lower BMI, but the risk of increased maternal body size for cases was not provided . No studies reported on the relation between maternal size and neonatal death or hypoxic–ischemic encephalopathy following presentation with DFM.…”

“…PRISMA flowchart. Twenty-three publications were identified as eligible but two were from one study (12,23), and three were from another study (10,11,24). One publication (25) that reported on presentation with decreased fetal movements was part of a larger cohort study (26 subsequent cohort study of 1086 women, the same authors also reported an increase in count-to-ten time in women with BMI > 30 kg/m 2 , though the effect size was very small, amounting to an increase of <2 min (26).…”

“…Primary outcome. Ten studies (13 publications) reported on the association between maternal size and presentation with DFM (5,(9)(10)(11)(12)(13)24,25,27,28,35). One study, Saastad et al (35), was at low risk of bias, but all other studies were at moderate to serious risk of bias in one or more domains (Table 1).…”

“…In addition to stillbirth, DFM is associated with preterm birth (3), cesarean section for fetal distress (4), fetal ª 2017 Nordic Federation of Societies of Obstetrics and Gynecology, Acta Obstetricia et Gynecologica Scandinavica 97 (2018) [13][14][15][16][17][18][19][20][21][22][23][24] growth restriction (FGR) (5,6), small-for-gestational-age (SGA) (7), and neurological impairment in offspring (8). It has been hypothesized that when exposed to a worsening intrauterine environment, the fetus conserves energy by reducing movement, and this is supported by studies showing an association between DFM and placental pathology (7,(9)(10)(11).…”