Risk Factors, Associations, and Outcomes of Reduced Fetal Movements: A Preliminary Cross-Sectional Study at Port Sudan Maternity Hospital

Background: Reduced fetal movements (RFM) are a significant concern in obstetric care. They often indicate fetal distress and are associated with adverse perinatal outcomes such as stillbirth and intrauterine growth restriction (IUGR). While RFM is recognized as a critical marker of fetal well-being, there is a limit to the data available on its risk factors and outcomes in the Port Sudan region. This study aimed to estimate risk factors and outcomes of pregnancies at risk due to RFM.

Methods: This was a cross-sectional hospital-based study, conducted from February to August 2022 at Port Sudan Maternity Hospital, focused on mothers with RFMs defined by the RCOG guidelines. A total of 33 cases were analyzed using a structured questionnaire, with data collected via direct interviews. Data analysis was performed using SPSS version 26.0 (IBM Corp., Armonk, NY), employing descriptive statistics, frequency tables, and cross-tabulations. Ethical approval was obtained, and participant confidentiality was ensured through anonymization.

Results: Most participants were married women aged 18 to 29 years, primarily housewives with diverse educational backgrounds. A minority reported medical conditions like diabetes (6.1%) and hypertension (3%), while pregnancy complications included preeclampsia (10%) and anemia (6.7%). The first episode of RFM was commonly reported before 28 weeks of gestation (34.4%). Normal vaginal delivery was the most frequent mode of birth (48.4%), with a significant number of pregnancies resulting in intrauterine fetal demise (IUFD) (53.3%). Additionally, 77.8% of newborns had five-minute APGAR scores below 7, and 42.9% had birth weights between 2.5 kg and 3.5 kg. About 12.1% of births in our study were stillbirths and all of them were preterm babies.

Conclusion: The study underscores the frequent serious implications of RFM on pregnancy outcomes with the majority presenting as low APGAR scores and IUFD. Early detection and timely management of RFM are crucial for improving maternal and neonatal outcomes. Tailored antenatal care (ANC) is needed to address the diverse risks associated with RFM.