Objectives Maternal report of reduced fetal movements (RFM) is a means of identifying fetal compromise in pregnancy. In live births RFM is associated with altered placental structure and function. Here, we explored associations between RFM, pregnancy characteristics, and the presence of placental abnormalities and fetal growth restriction (FGR) in cases of stillbirth. Methods A retrospective cohort study was carried out in a single UK tertiary maternity unit. Cases were divided into three groups: 109 women reporting RFM, 33 women with absent fetal movements (AFM) and 159 who did not report RFM before the diagnosis of stillbirth. Univariate and multivariate logistic regression was used to determine associations between RFM/AFM, pregnancy characteristics, placental insufficiency and the classification of the stillbirth. Results AFM or RFM were reported prior to diagnosis of stillbirth in 142 (47.2%) of cases. Pregnancies with RFM prior to diagnosis of stillbirth were independently associated with placental insufficiency (Odds Ratio (OR) 2.79, 95% Confidence Interval (CI) 1.84, 5.04) and were less frequently associated with maternal proteinuria (OR 0.16, 95% CI 0.07, 0.62) and previous pregnancy loss <24 weeks (OR 0.20, 95% CI 0.07, 0.70). When combined, AFM and RFM were less frequently reported in twin pregnancies ending in stillbirth and in intrapartum stillbirths. Conclusions The association between RFM and placental insufficiency was confirmed in cases of stillbirth. This provides further evidence that RFM is a symptom of placental insufficiency. Therefore, investigation after RFM should aim to identify placental dysfunction.

中文翻译：

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胎动减少之前的死产更常与胎盘功能不全有关：一项回顾性队列研究

目的 减少胎动 (RFM) 的产妇报告是识别妊娠期胎儿受损的一种方法。在活产中，RFM 与胎盘结构和功能的改变有关。在这里，我们探讨了死产情况下 RFM、妊娠特征以及胎盘异常和胎儿生长受限 (FGR) 之间的关联。方法 回顾性队列研究在一个英国三级产科进行。病例分为三组：109 名报告 RFM 的女性、33 名无胎动 (AFM) 的女性和 159 名在诊断死产前未报告 RFM 的女性。单变量和多变量逻辑回归用于确定 RFM/AFM、妊娠特征、胎盘功能不全和死产分类之间的关联。结果 142 例 (47.2%) 病例在死产诊断前报告了 AFM 或 RFM。在诊断为死产之前患有 RFM 的妊娠与胎盘功能不全独立相关（优势比 (OR) 2.79, 95% 置信区间 (CI) 1.84, 5.04）并且与母体蛋白尿的相关性较低（OR 0.16, 95% CI 0.07, 0.62) 和之前的妊娠丢失 <24 周 (OR 0.20, 95% CI 0.07, 0.70)。结合使用时，AFM 和 RFM 在双胎妊娠中以死产和产时死产告终的报道较少。结论 在死产病例中证实了 RFM 与胎盘功能不全之间的关联。这进一步证明 RFM 是胎盘功能不全的症状。因此，RFM 后的调查应旨在识别胎盘功能障碍。