Decreased fetal movements and long-term neurological morbidity of the offspring

Objective
While perception of decreased fetal movements (DFM) may be an indicator for adverse perinatal outcome, the long-term neurological outcome of these offspring remains unknown. In this study we examined whether maternal complaint of DFM is associated with higher prevalence of neurological morbidity of the offspring years thereafter.

Study Design
A population-based cohort analysis including deliveries between the years 1991 to 2014 in a tertiary referral hospital was conducted. Incidence of hospitalizations (up to age 18 years) due to various neurological conditions was compared between offspring of DFM-accompanied pregnancies, and those who were not. A Kaplan-Meyer survival curve was used to assess cumulative hospitalization incidence. A Cox proportional hazards model was used to control for baseline selected confounders.

Results
439 (0.18%) of 242,342 included deliveries were accompanied by complaint of DFM. Total neurological-related hospitalization rate and hospitalizations due to movement disorders, were higher among the exposed group (4.8% vs. 3.1%; OR=1.57, 95% CI 1.01-2.43; p=0.044; and 3.2% vs. 1.8%; OR=1.76, 95% CI 1.02-3.0; p=0.036, respectively; Table). Likewise, higher cumulative incidence of neurological-related hospitalizations was observed using a Kaplan-Meyer survival curve (log rank p-value = 0.019; Figure). This association between DFM and increased long-term neurological morbidity remained significant in the COX proportional hazards model controlling for gestational age (adjusted HR = 1.58; 95% CI 1.03–2.43, p=0.036).