Table 3

Impact of fetal movement counting on stillbirth and perinatal mortality

Source

Location and Type of Study

Intervention

Stillbirths/Perinatal outcomes


Reviews and meta-analyses


Mangesi et al. 2007 [22]

Peru, Denmark.

Meta-analysis (Cochrane). 3 RCTs included (N = 66 women).

Routine fetal movement counting (intervention) versus mixed or undefined fetal movement counting (controls).

SBR: weighted mean difference = 0.23 [95% confidence interval (CI): -0.61–1.07) [NS]

[Mean (SD) = 2.90 (1.90) vs. 2.67 (1.55) in intervention vs. control groups, respectively].


Intervention studies


Gomez et al. 2007 [166]

Peru. Hospital setting.

RCT. Pregnant women (N = 1400).

Compared two different charting methods: a novel fetal movement chart proposed by the Latin American Center for Perinatology (CLAP) (intervention) vs. the count-to-ten Cardiff chart method (comparison).

Fetal death (miscarriage+SB): Relative risk (RR) not estimable.

[0/700 in both groups].


Grant et al. 1989 [28]

UK, USA, Ireland, Sweden, Belgium.

Cluster RCT. 66 clusters. Pregnant women (N = 68654 women; N = 31993 intervention, N = 36661 controls).

Compared the impact on birth outcomes of asking mothers to keep routine kick charts (intervention) vs. not keeping kick charts (controls).

Unexplained late antepartum fetal death: 59/31993 (2.9/1000) vs. 58/36661 (2.7/1000) in intervention vs. control groups, respectively [NS].


Moore 1989 [27]

USA. Hospital setting.

Before-after pilot study (N = 2519 deliveries before intervention, N = 1864 after introduction of intervention.)

Assessed the impact of introducing formal fetal movement assessment (intervention) compared to no monitoring before the intervention (controls).

Fetal death (miscarriage+SB): 2.1/1000 vs. 8.7/1000 after vs. before, respectively. (χ2 = 6.8; P < 0.01)


Observational studies


De Muylder 1988 [24]

Zimbabwe. Hospital setting.

Prospective cohort study. High-risk pregnant women (N = 200).

Compared the obstetrical outcome among the patients with a normal kick chart (unexposed), compared to those with an abnormal count (exposed).

SBR: 19.4% vs. 0.7% in charts that went from normal to being abnormal vs. unexposed. (P < 0.001)

PMR: 22.2% vs. 2.7% for previously normal charts that became abnormal vs. unexposed (P < 0.001)


Lema et al. 1988 [23]

Kenya. Urban hospital setting.

Prospective cohort study. High-risk pregnant women (N = 110).

Compared birth outcomes among women with good fetal movements vs. poor fetal movements.

SBR: 12/1000 (1/83) vs 185/1000 (5/27) in the good vs. poor fetal movements group, respectively. No statistical significance data.


Sinha et al. 2007 [25]

UK. Hospital setting.

Retrospective cohort study. N = 180 case reports.

Compared the impact of reduced fetal movements (exposed) to women without reduced fetal movements (unexposed) on PMR.

PMR: RR not estimable.

[0/90 in the exposed vs. 0/90 in the control groups, respectively].

Intervention needed solely due to fetal compromise: 29/90 (32%) in the study vs. 19/90 (21%) in the control groups, respectively.


Romero Gutiérrez et al. 1994 [26]

Mexico. Hospital setting.

Prospective cohort study. Pregnant women (N = 200; N = 100 intervention, N = 100 controls) 32–41 wks gestation without risk factors.

Compared the impact of decreased fetal movement (exposed) vs. normal fetal movement (unexposed) on PMR.

PMR: No difference [NS]


Haws et al. BMC Pregnancy and Childbirth 2009 9(Suppl 1):S5   doi:10.1186/1471-2393-9-S1-S5

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