Saastad Eli, Tveit Julie Victoria Holm, Flenady Vicki, Stray-Pedersen Babill, Fretts Ruth C, Børdahl Per E, Frøen J Frederik
Norwegian Institute of Public Health, Division of Epidemiology, Oslo, Norway.
BMC Res Notes. 2010 Jan 4;3(1):2. doi: 10.1186/1756-0500-3-2.
Delayed maternal reporting of decreased fetal movement (DFM) is associated with adverse pregnancy outcomes. Inconsistent information on fetal activity to women during the antenatal period may result in delayed reporting of DFM. We aimed to evaluate an intervention of implementation of uniform information on fetal activity to women during the antenatal period.
In a prospective before-and-after study, singleton women presenting DFM in the third trimester across 14 hospitals in Norway were registered. Outcome measures were maternal behavior regarding reporting of DFM, concerns and stillbirth. In addition, cross-sectional studies of all women giving birth were undertaken to assess maternal concerns about fetal activity, and population-based data were obtained from the Medical Birth Registry Norway.
Pre- and post-intervention cohorts included 19 407 and 46 143 births with 1 215 and 3 038 women with DFM respectively. Among primiparous women with DFM, a reduction in delayed reporting of DFM (>/=48 hrs) OR 0.61 (95% CI 0.47-0.81) and stillbirths OR 0.36 (95% CI 0.19-0.69) was shown in the post-intervention period. No difference was shown in rates of consultations for DFM or maternal concerns. Stillbirth rates and maternal behavior among women who were of non-Western origin, smokers, overweight or >34 years old were unchanged.
Uniform information on fetal activity provided to pregnant women was associated with a reduction in the number of primiparous women who delayed reporting of DFM and a reduction of the stillbirth rates for primiparous women reporting DFM. The information did not appear to increase maternal concerns or rate of consultation. Due to different imperfections in different clinical settings, further studies in other populations replicating these findings are required.
孕妇延迟报告胎动减少（DFM）与不良妊娠结局相关。孕期向女性提供的关于胎儿活动的信息不一致可能导致DFM报告延迟。我们旨在评估一项在孕期向女性提供关于胎儿活动的统一信息的干预措施。
在一项前瞻性前后对照研究中，对挪威14家医院中孕晚期出现DFM的单胎孕妇进行登记。结局指标包括孕妇报告DFM的行为、担忧和死产情况。此外，对所有分娩女性进行横断面研究，以评估孕妇对胎儿活动的担忧，并从挪威医疗出生登记处获取基于人群的数据。
干预前和干预后队列分别包括19407例和46143例分娩，分别有1215例和3038例出现DFM的女性。在出现DFM的初产妇中，干预后期DFM延迟报告（≥48小时）的发生率降低，比值比为0.61（95%置信区间0.47 - 0.81），死产发生率降低，比值比为0.36（95%置信区间0.19 - 0.69）。DFM咨询率或孕妇担忧率无差异。非西方血统、吸烟、超重或年龄>34岁的女性的死产率和孕妇行为没有变化。
向孕妇提供关于胎儿活动的统一信息与初产妇延迟报告DFM的人数减少以及报告DFM的初产妇死产率降低相关。该信息似乎并未增加孕妇的担忧或咨询率。由于不同临床环境存在不同缺陷，需要在其他人群中重复这些发现进行进一步研究。
