ABSTRACT: Background: Fetal movement counting may improve timely identification of
decreased fetal activity and thereby contribute to prevent adverse pregnancy outcomes, but it
may also contribute to maternal concern. This study aimed to test whether fetal movement
counting increased maternal concern. Methods: In a multicenter, controlled trial 1,013
women with a singleton pregnancy were randomly assigned either to perform daily fetal movement
counting from pregnancy week 28 or to follow standard Norwegian antenatal care where
fetal movement counting is not encouraged. The primary outcome was maternal concern, measured
by the Cambridge Worry Scale. Analysis was by intention-to-treat. Results: The means
and SDs on Cambridge Worry Scale scores were 0.77 (0.55) and 0.90 (0.62) for the intervention
and the control groups, respectively, a mean difference between the groups of 0.14 (95%
CI: 0.06–0.21, p < 0.001). Decreased fetal activity was of concern to 433 women once or more
during pregnancy, 45 and 42 percent in the intervention and control groups, respectively (relative
risk = 1.1, 95% CI: 0.9–1.2). Seventy-nine percent of the women responded favorably to
the use of counting charts. Conclusions: Women who performed fetal movement counting in
the third trimester reported less concern than those in the control group. The frequency of
maternal report of concern about decreased fetal activity was similar between the groups. Most
women considered the use of a counting chart to be positive. (BIRTH 39:1 March 2012)
Key words: antenatal care, concern, fetal movement, fetal movement counting, worry
ABSTRACT: Background: Fetal movement counting may improve timely identification ofdecreased fetal activity and thereby contribute to prevent adverse pregnancy outcomes, but itmay also contribute to maternal concern. This study aimed to test whether fetal movementcounting increased maternal concern. Methods: In a multicenter, controlled trial 1,013women with a singleton pregnancy were randomly assigned either to perform daily fetal movementcounting from pregnancy week 28 or to follow standard Norwegian antenatal care wherefetal movement counting is not encouraged. The primary outcome was maternal concern, measuredby the Cambridge Worry Scale. Analysis was by intention-to-treat. Results: The meansand SDs on Cambridge Worry Scale scores were 0.77 (0.55) and 0.90 (0.62) for the interventionand the control groups, respectively, a mean difference between the groups of 0.14 (95%CI: 0.06–0.21, p < 0.001). Decreased fetal activity was of concern to 433 women once or moreduring pregnancy, 45 and 42 percent in the intervention and control groups, respectively (relativerisk = 1.1, 95% CI: 0.9–1.2). Seventy-nine percent of the women responded favorably tothe use of counting charts. Conclusions: Women who performed fetal movement counting inthe third trimester reported less concern than those in the control group. The frequency ofmaternal report of concern about decreased fetal activity was similar between the groups. Mostwomen considered the use of a counting chart to be positive. (BIRTH 39:1 March 2012)Key words: antenatal care, concern, fetal movement, fetal movement counting, worry
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