The Obstetrics and Gynecology Division, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
The Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eur J Obstet Gynecol Reprod Biol. 2019 Oct;241:1-5. doi: 10.1016/j.ejogrb.2019.07.034. Epub 2019 Aug 2.
While maternal perception of decreased fetal movements during advanced stages of pregnancy may be an indicator for adverse perinatal outcome, the long-term neurological outcome of offspring of affected pregnancies remains largely unknown.
To examine whether maternal complaint of decreased fetal movements is associated with adverse perinatal outcomes, and to assess the implications of decreased fetal movements on long-term neurological morbidity of the offspring.
A single center cohort analysis including deliveries between the years 1991-2014 was conducted. The association between decreased fetal movements and adverse perinatal outcome was evaluated using a general estimation equation (GEE) multivariable analyses. Incidence of hospitalizations (up to age 18 years) due to various neurological conditions was compared between offspring of affected pregnancies, and those who were not, using a Kaplan-Meyer survival curve. A Cox proportional hazards model was used to control for confounders.
439 (0.18%) of 242,342 deliveries included in this study were accompanied by maternal complaint of decreased fetal movements. Perinatal outcome was comparable between the groups, with no cases of perinatal mortality observed among the exposed group. Total neurological-related hospitalization rate of the offspring, as well as hospitalizations due to movement disorders, were higher among the exposed group (Kaplan-Meyer log-rank test P < 0.05). This association between decreased fetal movements and increased long-term neurological hospitalization proved to be independent of potential confounders with an adjusted hazard ratio of 1.54 (95% CI 1.0-2.37).
Maternal complaint of decreased fetal movements does not predict adverse perinatal outcome but is associated with an elevated risk for long-term neurological morbidity of the offspring.
尽管孕妇在妊娠晚期感知到胎动减少可能是不良围产结局的指标，但受影响妊娠的后代的长期神经发育结局在很大程度上仍不清楚。
探讨孕妇自述胎动减少是否与不良围产结局相关，并评估胎动减少对后代长期神经发育发病率的影响。
进行了一项单中心队列分析，纳入了 1991 年至 2014 年期间的分娩。使用广义估计方程（GEE）多变量分析评估胎动减少与不良围产结局之间的关联。使用 Kaplan-Meier 生存曲线比较受影响妊娠和未受影响妊娠的后代因各种神经疾病住院的发生率。使用 Cox 比例风险模型控制混杂因素。
在纳入的 242342 例分娩中，有 439 例（0.18%）孕妇自述胎动减少。两组围产结局相当，未观察到暴露组有围产儿死亡病例。暴露组的后代总神经相关住院率以及因运动障碍而住院的比例均较高（Kaplan-Meier 对数秩检验 P<0.05）。胎动减少与长期神经住院率增加之间的这种关联独立于潜在混杂因素，调整后的风险比为 1.54（95%CI 1.0-2.37）。
孕妇自述胎动减少并不能预测不良围产结局，但与后代长期神经发育发病率升高相关。
