Maternally perceived fetal movement patterns: The influence of body mass index

Bradford, Billie; Cronin, Robin; McKinlay, Christopher J. D.; Thompson, John M. D.; McCowan, Lesley

doi:10.1016/j.earlhumdev.2019.104922

Cited by 8 publications

(4 citation statements)

References 35 publications

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“…A systematic review of obesity and foetal movements identified limited data and reported that maternal body size was not associated with altered ability to perceive foetal movements (4 studies of 95 women; very low-quality evidence) [ 14 ]. In a further study, maternal reporting of foetal movement strength and frequency was not different in relation to obesity, highlighting that maternal BMI is not a barrier to the detection of foetal movements and the clinical importance of a presentation with foetal movement concerns is not diminished by maternal body size [ 15 ]. As such, all women regardless of BMI, attending with concerns about foetal movements, should be treated the same.…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review of the literature supported these suggestions but found that there was limited evidence of the association of increased maternal BMI, RFM and outcomes [ 14 ]. However, available data from a study that included 233 obese women suggested that women with obesity feel changes in strength and frequency in foetal movements in the same proportion as non-obese women [ 15 ]. To optimise the quality of information available from the case-control studies and evaluate the influence of confounding factors, we established the Collaborative Individual Participant Data (IPD) Meta-analysis of Sleep and Stillbirth (CRIBSS).…”

Section: Introductionmentioning

confidence: 99%

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A better understanding of the association between maternal perception of foetal movements and late stillbirth—findings from an individual participant data meta-analysis

Thompson

Wilson

Bradford

et al. 2021

BMC Med

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Background Late stillbirth continues to affect 3–4/1000 pregnancies in high-resource settings, with even higher rates in low-resource settings. Reduced foetal movements are frequently reported by women prior to foetal death, but there remains a poor understanding of the reasons and how to deal with this symptom clinically, particularly during the preterm phase of gestation. We aimed to determine which women are at the greatest odds of stillbirth in relation to the maternal report of foetal movements in late pregnancy (≥ 28 weeks’ gestation). Methods This is an individual participant data meta-analysis of all identified case-control studies of late stillbirth. Studies included in the IPD were two from New Zealand, one from Australia, one from the UK and an internet-based study based out of the USA. There were a total of 851 late stillbirths, and 2257 controls with ongoing pregnancies. Results Increasing strength of foetal movements was the most commonly reported (> 60%) pattern by women in late pregnancy, which were associated with a decreased odds of late stillbirth (adjusted odds ratio (aOR) = 0.20, 95% CI 0.15 to 0.27). Compared to no change in strength or frequency women reporting decreased frequency of movements in the last 2 weeks had increased odds of late stillbirth (aOR = 2.33, 95% CI 1.73 to 3.14). Interaction analysis showed increased strength of movements had a greater protective effect and decreased frequency of movements greater odds of late stillbirth at preterm gestations (28–36 weeks’ gestation). Foetal hiccups (aOR = 0.45, 95% CI 0.36 to 0.58) and regular episodes of vigorous movement (aOR = 0.67, 95% CI 0.52 to 0.87) were associated with decreased odds of late stillbirth. A single episode of unusually vigorous movement was associated with increased odds (aOR = 2.86, 95% CI 2.01 to 4.07), which was higher in women at term. Conclusions Reduced foetal movements are associated with late stillbirth, with the association strongest at preterm gestations. Foetal hiccups and multiple episodes of vigorous movements are reassuring at all gestations after 28 weeks’ gestation, whereas a single episode of vigorous movement is associated with stillbirth at term.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A better understanding of the association between maternal perception of foetal movements and late stillbirth—findings from an individual participant data meta-analysis

Thompson

Wilson

Bradford

et al. 2021

BMC Med

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“…For non-linear dose-response relation, the covarianceadjusted multiple variables regression model was used to estimate and test the overall effect of curvilinear doseresponses. For linear dose-response relationship, a slope for each study was estimated as the first step, then derived an overall estimates by weighted average of the individual slopes [26].…”

Section: Discussionmentioning

confidence: 99%

Body mass index increases the lymph node metastasis risk of breast cancer: a dose-response meta-analysis with 52904 subjects from 20 cohort studies

Wang

Cai

et al. 2020

BMC Cancer

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Background: Since body mass index (BMI) is a convincing risk factor for breast cancer, it is speculated to be associated with lymph node metastasis. However, epidemiological studies are inconclusive. Therefore, this study was conducted to investigate the effect of BMI on the lymph node metastasis risk of breast cancer. Methods: Cohort studies that evaluating BMI and lymph node metastasis in breast cancer were selected through various databases including PubMed, PubMed Central (PMC), Web of science, the China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals (VIP) and Wanfang Data Knowledge Service Platform (WanFang) until November 30, 2019. The two-stage, random effect meta-analysis was performed to assess the dose-response relationship between BMI and lymph node metastasis risk. Between-study heterogeneity was assessed using I 2. Subgroup analysis was done to find possible sources of heterogeneity. Results: We included a total of 20 studies enrolling 52,904 participants. The summary relative risk (RR) (1.10, 95%CI: 1.06-1.15) suggested a significant effect of BMI on the lymph node metastasis risk of breast cancer. The doseresponse meta-analysis (RR = 1.01, 95%CI: 1.00-1.01) indicated a positive linear association between BMI and lymph node metastasis risk. For every 1 kg/m 2 increment of BMI, the risk of lymph node metastasis increased by 0.89%. In subgroup analyses, positive linear dose-response relationships between BMI and lymph node metastasis risk were observed among Asian, European, American, premenopausal, postmenopausal, study period less than 5 years, and more than 5 years groups. For every 1 kg/m 2 increment of BMI, the risk of lymph node metastasis increased by 0.99, 0.85, 0.61, 1.44, 1.45, 2.22, and 0.61%, respectively. Conclusion: BMI significantly increases the lymph node metastasis risk of breast cancer as linear dose-response reaction. Further studies are needed to identify this association.

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“…It has been suggested that perception of fetal movement may be altered in women with increased body size (53). But a number of studies have compared perception of fetal movements in women with high BMI and normal BMI and found that perception is not different (48,54,55). In women with anterior placenta, fetal movement counting times are similar to other placental locations from 24 weeks' gestation (56).…”

Section: Fetal Movements In Early Third Trimestermentioning

confidence: 99%