Reduced fetal movements and maternal medication - new pregnancy risk factors for neurodevelopmental disability in childhood

Abstract

A case-control study was undertaken of 471 children on the Nottingham Special Needs Register (SNR) who were born in one of the two maternity units in the city between 1987 and 1993 (inclusive). Controls were selected as the next infant born at the same hospital following each index case. The aim of the study was to identify risk factors on the Nottingham Obstetric Database for a baby subsequently appearing on the SNR. Disability was analysed by both ICD-9 coding and functional assessment. Factors which independently and significantly predicted a child's likelihood of being on the SNR were breech presentation (adjusted odds ratio (OR) = 4.0), congenital abnormality (OR=4.9), intrapartum fetal distress (OR=1.7), fetal growth restriction (OR=2.0), socioeconomic deprivation (OR=1.8), prematurity (OR=2.2), reduced fetal movements (OR=2.5) and medication in pregnancy (OR=10.4). To our knowledge the last two factors have not previously been reported as risk predictors for neurodevelopmental disability.

Passive Fetal Movement Recognition Approaches Using Hyperparameter Tuned LightGBM Model and Bayesian Optimization

“…Continuous quantitative recording of fetal movements allows reliable recognition of fetal impairment and enables timely intervention to reduce mortality [ 5 ]. Maternal perception of altered or decreased fetal movement is associated with stillbirth [ 13 , 14 ] and with other adverse outcomes, including maternal-fetal hemorrhage, growth restriction, congenital anomalies, and long-term neurodevelopmental disorders [ 15 – 20 ]. Usually, maternal recurrent perception of fetal movements is considered a sign of fetal health [ 17 , 21 , 22 ].…”

A kick in the right direction - reduced fetal movements and stillbirth prevention

“…Multiple studies using various approaches have associated reduced fetal movements (RFM) with stillbirth and small for gestational age infants [ 1 , 2 ]. More recently, RFM has been linked to neurodevelopmental delay and a lack of response to treatment for hypoxic-ischaemic encephalopathy [ 3 , 4 ]. The relationship between adverse pregnancy or infant outcome is thought to be mediated by placental dysfunction [ 5 ]; thus RFM represents a symptom of placental insufficiency, when a placenta cannot meet the metabolic demands of the growing fetus.…”