{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:38:26Z","timestamp":1791463106242,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T00:00:00Z","timestamp":1694131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterize obstetric outcomes and the association with umbilical cord (UC) complications among women complaining of reduced fetal movements (RFMs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort compared women with a perception of RFMs within 2\u2009weeks prior to delivery with women who reported no changes in fetal movements in terms of maternal characteristics and neonatal outcomes. A primary outcome of UC complications at delivery was defined. Multivariable regression analysis was performed to identify independent associations with RFMs and UC complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 46\u2009103 women were included, 2591 (5.6%) of whom reported RFMs and 43\u2009512 (94.4%) in the control group. Compared with controls, the RFM group was more likely to be nulliparous (42.6% vs 32.2%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), smokers (6.4% vs 5.4%, <jats:italic>P<\/jats:italic>\u2009=\u20090.029), or obese (body mass index &gt;30) (16.4% vs 11.6%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). They were also more likely to have an anterior placenta (56.2% vs 51.8%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and poly\/oligohydramnios (0.7% vs 0.4%, <jats:italic>P<\/jats:italic>\u2009=\u20090.015 and 3.6% vs 2.1%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001, respectively). Induction of labor was more common in the RFM group (33.9% vs 19.7%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), as well as meconium (16.8% vs 15.0%, <jats:italic>P<\/jats:italic>\u2009=\u20090.026) and vacuum extractions (10.1% vs 8.0%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Higher rates of stillbirth and the severe composite neonatal outcome were observed in the RFM group (1.5% vs 0.2%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 and 0.6% vs 0.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.010, respectively). The RFM group was characterized by higher rates of triple nuchal cord (<jats:italic>P<\/jats:italic>\u2009=\u20090.015), UC around body or neck (32.2% vs 29.6%, <jats:italic>P<\/jats:italic>\u2009=\u20090.010), and true knot (2.3% vs 1.4%, <jats:italic>P<\/jats:italic>\u2009=\u20090.002). Multivariable logistic regression found RFMs to be independently associated with triple nuchal cord and with a true cord knot. A sub\u2010analysis including only cases of stillbirth (<jats:italic>n<\/jats:italic>\u2009=\u2009127) revealed even higher rates of UC complications: 7% of all stillbirths presented with a true cord knot (20% true knots were found in stillbirths preceded by RFMs vs 6.1% in stillbirth cases without RFMs). Additionally, 33.8% of all stillbirths presented with nuchal cord (40% preceded by RFMs vs 33.3% without RFMs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RFMs are associated with increased risk of UC complications observed at delivery, as well as increased risk of stillbirth and neonatal adverse outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15076","type":"journal-article","created":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T02:39:25Z","timestamp":1694227165000},"page":"933-941","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Are reduced fetal movements \u201cmerely\u201d a maternal perception or truly a reflection of umbilical cord complications? 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