Fetal Movement Counting in Prolonged Pregnancies: The COMPTAMAF Prospective Randomized Trial

Abstract

In prolonged pregnancies, the risks of neonatal morbidity and mortality are increased. The aim of this trial was to assess the benefits of maternal information about fetal movement (FM) counting on neonatal outcomes in prolonged pregnancy. It was a prospective, single center, randomized, open-label study conducted from October 2019 to March 2022. Intention-to-treat analyses were performed on 278 patients randomized into two 1:1 groups (control group and FM counting group). The primary outcome was a composite score of neonatal morbidity (presence of two of the following items: fetal heart rate abnormality at delivery, Apgar score of <7 at 5 min, umbilical cord arterial pH of <7.20, and acute respiratory distress with mutation in neonatal intensive care unit). There was no significant difference between the two groups in the rate of neonatal morbidity (14.0% in the FM counting group versus 22.9% in the standard information group; p = 0.063; OR 0.55, 95% CI 0.29−1.0). In this study, fetal movement counting for women in prolonged pregnancy failed to demonstrate a significant reduction in adverse neonatal outcomes.

Keywords: decreased fetal movements; fetal movement counting; neonatal morbidity; prolonged pregnancy.

Figure 1

Flow chart. FMC: fetal movements counting; ITT: intention-to-treat.

Figure 2

Odds ratio for neonatal morbidity criteria and their 95% confidence interval. * 18 missing data (10 from the “FM counting” group, 8 from the “control” group), analyses performed without missing data. FHR: fetal heart rate; pHa: umbilical cord arterial pH; ARD: acute respiratory distress; ICU: intensive care unit.