Impact of Covid-19 on Attendances for a 1st Episode of Reduced Fetal Movements: A Retrospective Observational Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2021 Jun 25

PMID 34170973

Citations 2

Authors

Laia Marques-Fernandez

Swati Sharma

Una Mannu

Hsu Phern Chong

Affiliations

Soon will be listed here.

Abstract

Background: Prior studies have demonstrated an increased stillbirth rate. It was suggested that the COVID-19 pandemic may have impacted on attendances for reduced fetal movements. Thus, we sought to ascertain the impact of the pandemic on attendances for reduced fetal movements (RFM) in our unit, ultrasound provision for reduced fetal movements, and the stillbirth rate.

Methods: This was a single site retrospective cohort study involving all women complaining of a 1st episode of reduced fetal movements between 01/03/2020-30/04/2020 (COVID) to 01/03/2019-30/04/2019 (Pre-COVID). Data were retrieved from computerised hospital records and statistical analyses were performed using GraphPad Prism and SPSS.

Results: 22% (179/810) of women presented with a 1st episode of reduced fetal movements Pre-COVID compared to 18% (145/803) during COVID (p = 0.047). Primiparous women were significantly over-represented in this population with a 1.4-fold increase in attendances during COVID (67% vs 48%, p = 0.0005). Neither the total stillbirth rate nor the stillbirth rate amongst women who presented with reduced fetal movements changed during COVID. Ultrasound provision was not impacted by COVID with 95% of the scans performed according to local guidelines, compared to Pre-COVID (74%, p = 0.0001).

Conclusions: There is a significant decrease in 1st attendances for reduced fetal movements during COVID-19 pandemic. Primiparous women were 1.4 times more likely to attend with RFM. Women should be reassured that COVID-19 has not resulted in a decreased provision of care for RFM, and has not impacted on the stillbirth rate.

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References

Strand L, Barnett A, Tong S . The influence of season and ambient temperature on birth outcomes: a review of the epidemiological literature. Environ Res. 2011; 111(3):451-62. DOI: 10.1016/j.envres.2011.01.023. View

Bhatia M, Mitsi V, Court L, Thampi P, El-Nasharty M, Hesham S . The outcomes of pregnancies with reduced fetal movements: A retrospective cohort study. Acta Obstet Gynecol Scand. 2019; 98(11):1450-1454. DOI: 10.1111/aogs.13671. View

Lee S, Steer P, Filippi V . Seasonal patterns and preterm birth: a systematic review of the literature and an analysis in a London-based cohort. BJOG. 2006; 113(11):1280-8. DOI: 10.1111/j.1471-0528.2006.01055.x. View

McCarthy C, Meaney S, ODonoghue K . Perinatal outcomes of reduced fetal movements: a cohort study. BMC Pregnancy Childbirth. 2016; 16(1):169. PMC: 4950725. DOI: 10.1186/s12884-016-0964-2. View

Watson C . Stillbirth rate rises dramatically during pandemic. Nature. 2020; 585(7826):490-491. DOI: 10.1038/d41586-020-02618-5. View

Kc A, Gurung R, Kinney M, Sunny A, Moinuddin M, Basnet O . Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study. Lancet Glob Health. 2020; 8(10):e1273-e1281. PMC: 7417164. DOI: 10.1016/S2214-109X(20)30345-4. View

Webster P . Virtual health care in the era of COVID-19. Lancet. 2020; 395(10231):1180-1181. PMC: 7146660. DOI: 10.1016/S0140-6736(20)30818-7. View

Khalil A, von Dadelszen P, Draycott T, Ugwumadu A, OBrien P, Magee L . Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic. JAMA. 2020; . PMC: 7435343. DOI: 10.1001/jama.2020.12746. View

Norman J, Heazell A, Rodriguez A, Weir C, Stock S, Calderwood C . Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a stepped wedge, cluster-randomised trial. Lancet. 2018; 392(10158):1629-1638. PMC: 6215771. DOI: 10.1016/S0140-6736(18)31543-5. View

10.

Lillie P, Samson A, Li A, Adams K, Capstick R, Barlow G . Novel coronavirus disease (Covid-19): The first two patients in the UK with person to person transmission. J Infect. 2020; 80(5):578-606. PMC: 7127394. DOI: 10.1016/j.jinf.2020.02.020. View

11.

Efkarpidis S, Alexopoulos E, Kean L, Liu D, Fay T . Case-control study of factors associated with intrauterine fetal deaths. MedGenMed. 2004; 6(2):53. PMC: 1395755. View

12.

Scala C, Bhide A, Familiari A, Pagani G, Khalil A, Papageorghiou A . Number of episodes of reduced fetal movement at term: association with adverse perinatal outcome. Am J Obstet Gynecol. 2015; 213(5):678.e1-6. DOI: 10.1016/j.ajog.2015.07.015. View

13.

Rayburn W . Fetal body movement monitoring. Obstet Gynecol Clin North Am. 1990; 17(1):95-110. View

14.

Auger N, Fraser W, Smargiassi A, Bilodeau-Bertrand M, Kosatsky T . Elevated outdoor temperatures and risk of stillbirth. Int J Epidemiol. 2016; 46(1):200-208. PMC: 5837696. DOI: 10.1093/ije/dyw077. View

15.

Rosenbaum L . The Untold Toll - The Pandemic's Effects on Patients without Covid-19. N Engl J Med. 2020; 382(24):2368-2371. DOI: 10.1056/NEJMms2009984. View

16.

Propper C, Stoye G, Zaranko B . The Wider Impacts of the Coronavirus Pandemic on the NHS. Fisc Stud. 2020; 41(2):345-356. PMC: 7301040. DOI: 10.1111/1475-5890.12227. View

17.

Stowe J, Smith H, Thurland K, Ramsay M, Andrews N, Ladhani S . Stillbirths During the COVID-19 Pandemic in England, April-June 2020. JAMA. 2020; 325(1):86-87. PMC: 7786243. DOI: 10.1001/jama.2020.21369. View

18.

Marsal K . Ultrasonic assessment of fetal activity. Clin Obstet Gynaecol. 1983; 10(3):541-63. View