Predictive factors in pregnancies with reduced fetal movements: a pilot study

Area of Science:

• Perinatal medicine
• Maternal-fetal medicine
• Neonatal outcomes

Background:

• Reduced fetal movements (RFM) in pregnancies pose risks for adverse neonatal outcomes and stillbirth.
• Early identification of high-risk pregnancies is crucial for timely intervention.

Purpose of the Study:

• To evaluate Doppler measurements and angiogenic factors as predictors of adverse neonatal outcomes in pregnancies with RFM.
• To assess the impact of parity on the predictive model for adverse neonatal outcomes.

Main Methods:

• A prospective pilot cohort study involving 3243 women with RFM.
• Doppler examinations of fetal arteries and maternal blood sampling for angiogenic factors were performed in a subset of participants.
• Adverse neonatal outcomes included low Apgar score, umbilical cord acidosis, NICU transfer, stillbirth, and small for gestational age.

Main Results:

• No significant difference in adverse neonatal outcomes between the Doppler and standard care groups (14.1% vs. 11.7%).
• The Doppler group exhibited a higher rate of obstetrical interventions (28% vs. 5.4%).
• The predictive model for adverse outcomes using angiogenic factors had an AUC of 0.73, improving to 0.89 when parity was included.

Conclusions:

• Angiogenic factors may aid in predicting neonatal outcomes in RFM pregnancies.
• Parity is a significant factor in the predictive model for adverse neonatal outcomes.
• Additional Doppler examinations correlated with increased obstetrical intervention rates.