Tohoku J. Exp. Med., 2022 May, 257(1)

Increased Difficulties in Maternal Perception of Decreased Fetal Movement in Cases of Severe Fetal Growth Restriction: A Population-Based Study in Japan

Shinsuke Tokoro,¹ Shigeki Koshida,² Shunichiro Tsuji,¹ Daisuke Katsura,¹ Tetsuo Ono,³ Takashi Murakami¹ and Kentaro Takahashi²

¹Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Shiga, Japan
²Perinatal Center, Shiga University of Medical Science, Otsu, Shiga, Japan
³Department of Obstetrics and Gynecology, Omihachiman Community Medical Center, Omihachiman, Shiga,Japan

Fetal growth restriction (FGR) is defined as fetuses who have failed to achieve a normal weight for gestational age. FGR is associated with adverse perinatal outcomes, including stillbirth. Pregnant women often perceive decreased fetal movements before intrauterine fetal death. Previous reports on the association between fetal movements and FGR have mainly targeted livebirths, with few focusing on stillbirths. Studying stillbirths, not livebirths, may help improve perinatal adverse outcomes. This study evaluated the association between FGR leading to stillbirth and maternal perception of decreased fetal movement. This was a population-based study reviewing all stillbirths in Shiga Prefecture, Japan for 10 years. We analyzed 219 stillbirth cases, those with versus without FGR. We then compared maternal visits to healthcare providers due to perception of decreased fetal movement between these two groups. There were 82 stillbirths with FGR, and the remaining 137 stillbirth were without FGR. Women with FGR, compared with those without, were significantly less often to visit the outpatient department due to decreased fetal movement (30%; 25/82 vs. 46%; 63/137: P = 0.034). Pregnant women have more difficulty perceiving decreased fetal movements in cases with severe FGR than in those without FGR. Healthcare providers, including midwives, may need to closely monitor FGR pregnancy in addition to instructing pregnant women to be aware of decreased fetal movement.

Keywords —— fetal growth restriction; fetal movement; population-based study; stillbirth

© 2022 Tohoku University Medical Press

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Tohoku J. Exp. Med 2022, 257, 17-22.

Correspondence: Shigeki Koshida, Perinatal Center, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.

e-mail: koshida@belle.shiga-med.ac.jp