{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T17:52:34Z","timestamp":1791741154171,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Women experiencing reduced fetal movements (RFM) have an increased risk of adverse pregnancy outcomes (APO). This study aimed to identify factors most associated with APO in RFM pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Individual participant data meta\u2010analysis (IPD\u2010MA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Multiple maternity units across the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population or Sample<\/jats:title><jats:p>1175 singleton pregnancies with RFM between 28<jats:sup>+0<\/jats:sup> and 41<jats:sup>+0<\/jats:sup> weeks' gestation from four prospective cohorts and two randomised controlled trials (RCTs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Factors associated with APO were assessed using two\u2010stage IPD\u2010MA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>A composite adverse pregnancy outcome, including: adjusted Odds Ratio, stillbirth, fetal growth restriction (FGR, birthweight \u2264\u20093rd centile) and neonatal intensive care unit (NICU) admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Results<\/jats:title><jats:p>APO occurred in 7.7% of RFM pregnancies, with FGR being the most common complication (4.6%). The strongest associations with APO were observed for abnormal fetal heart rate (adjusted Odds Ratio (aOR)\u2009=\u20093.65, 95% CI: 1.84\u20137.23), cigarette smoking (aOR\u2009=\u20092.96, 95% CI: 1.36\u20136.44) and maternal past medical history (aOR\u2009=\u20092.35, 95% CI: 1.14\u20134.82). Lower estimated fetal weight (EFW) centile was also significantly associated with APO (aOR\u2009=\u20090.97, 95% CI: 0.95\u20130.99), though substantial heterogeneity was present between studies (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200980.74%, <jats:italic>Q<\/jats:italic>\u2010statistic: <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>IPD\u2010MA enabled the synthesis of individual\u2010level data across studies, allowing for more accurate and reliable associations by accounting for heterogeneity. Further work is required to investigate the model's generalisability across diverse populations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18132","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:25:12Z","timestamp":1742196312000},"page":"1000-1009","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Risk Factors for Adverse Pregnancy Outcomes in Reduced Fetal Movement: An <scp>IPD<\/scp> Meta\u2010Analysis"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7535-1214","authenticated-orcid":false,"given":"Yongyi","family":"Lu","sequence":"first","affiliation":[{"name":"Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health The University of Manchester  Manchester 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