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Staged fetal responses to maternal hunger and eating, as described by participants. Typical descriptions of fetal activity in relation to meal stage, with numbers of participants making a statement of this type.
Source publication
Background
Maternal perception of decreased fetal movements is a specific indicator of fetal compromise, notably in the context of poor fetal growth. There is currently no agreed numerical definition of decreased fetal movements, with the subjective perception of a decrease on the part of the mother being the most significant definition clinically....
Context in source publication
Context 1
... seems to happen several times a day; like I suppose it is more around meal times, like before breakfast, she starts getting a bit excited, but yeah, afternoon tea time; any of those times as well, she's still, she goes: "Oh yeah, food's on the way, yay." … after a meal she's completely silent.... usually for, even up to an hour she'll not, like I won't feel a single movement 'cause it's almost just like she's just chowing down and happy. (Ruth, 39 weeks) Fetal activity as described by women in relation to hun- ger and eating demonstrated a developmental pattern over the course of a mealtime episode, with staged responses interpreted by mothers as being indicative of anticipation, hunger, appreciation of food and satiation, as represented in Figure 1. ...Similar publications
Fetal movement is an important biological index of fetal well-being. Since 2008, we have been developing an original capacitive acceleration sensor and device that a pregnant woman can easily use to record fetal movement by herself at home during sleep. In this study, we report a newly developed automated software system for analyzing recorded feta...
Citations
... Both overnourishment as well as undernourishment of mother during pregnancy is associated with a risk factor of obesity in the offspring. Incidentally, maternal obesity during pregnancy reduces the mass of neurons that expresses leptin receptors and may cause leptin resistance, while undernutrition or malnutrition causes the delayed response to presynaptic GABA and postsynaptic AgRP neurons to stimulus [42,43]. e leptin deficiency is also associated with decreases in BAT stores. ...
The incidence of obesity and over bodyweight is emerging as a major health concern. Obesity is a complex metabolic disease with multiple pathophysiological clinical conditions as comorbidities are associated with obesity such as diabetes, hypertension, cardiovascular disorders, sleep apnea, osteoarthritis, some cancers, and inflammation-based clinical conditions. In obese individuals, adipocyte cells increased the expression of leptin, angiotensin, adipocytokines, plasminogen activators, and C-reactive protein. Currently, options for treatment and lifestyle behaviors interventions are limited, and keeping a healthy lifestyle is challenging. Various types of phytochemicals have been investigated for antiobesity potential. Here, we discuss pathophysiology and signaling pathways in obesity, epigenetic regulations, regulatory mechanism, functional ingredients in natural antiobesity products, and therapeutic application of phytochemicals in obesity.
... To the best of our knowledge, this is the first study with a significantly high number of patients which analyzed the CTG changes in maternal COVID-19 infection using threetier FHR system [22] and documented all CTG trace parameters according to the COVID-19 severity. Numerous factors or circumstances have influence on the characteristics of the FHR pattern, including the time of the day, position and activity of the mother, movement of the fetus [24][25][26][27]. In the current study, we chose the optimal timing, activity and position to maximize oxygenation of the fetus: postprandial, in the morning, at rest, and semi-sitting position. ...
Objectives
We aimed to evaluate the cardiotocograph (CTG) traces of 224 women infected with novel coronavirus 2019 (COVID-19) and analyze whether changes in the CTG traces are related to the severity of COVID-19.
Methods
We designed a prospective cohort study. Two-hundred and twenty-four women who had a single pregnancy of 32 weeks or more, and tested positive for SARS-CoV-2 were included. Clinical diagnosis and classifications were made according to the Chinese management guideline for COVID-19 (version 6.0). Patients were classified into categories as mild, moderate, severe and the CTG traces were observed comparing the hospital admission with the third day of positivity.
Results
There was no statistically significant relationship between COVID-19 severity and CTG category, variability, tachycardia, bradycardia, acceleration, deceleration, and uterine contractility, Apgar 1st and 5th min.
Conclusions
Maternal COVID-19 infection can cause changes that can be observed in CTG. Regardless of the severity of the disease, COVID-19 infection is associated with changes in CTG. The increase in the baseline is the most obvious change.
... The references, and exclusion reasons for these 56 excluded studies are provided in Additional file 3. This resulted in the inclusion of nine studies across 11 publications [28][29][30][31][32][33][34][35][36][37][38]. Figure 2 illustrates the search and selection process. Table 1 presents the summary characteristics of the included studies. ...
... Table 1 presents the summary characteristics of the included studies. Three studies (four reports) were conducted in Sweden [28,32,33,36], three in Australia [34,35,37], two in the UK [31,38] and one (two reports) in New Zealand [29,30]. The majority of the studies (n = 6) were conducted from 2011 onwards, with one conducted in 1986 [31], and for two, the study dates were not provided [29,30,36]. ...
... Three studies (four reports) were conducted in Sweden [28,32,33,36], three in Australia [34,35,37], two in the UK [31,38] and one (two reports) in New Zealand [29,30]. The majority of the studies (n = 6) were conducted from 2011 onwards, with one conducted in 1986 [31], and for two, the study dates were not provided [29,30,36]. Data collection involved the use of questionnaires with open-ended response options in six studies [28,[31][32][33][34][35][36][37] and interviews in the remaining three studies [29,30,36,38]. ...
Background
Raising awareness of the importance of fetal movements (FMs) and advising women on the appropriate action to take if they experience reduced FMs, is important for minimising or avoiding adverse perinatal outcomes. To gain insight and understanding of women’s perspectives of assessing FMs in pregnancy, we conducted a qualitative evidence synthesis.
Methods
A qualitative evidence synthesis using thematic synthesis was conducted. Studies were eligible if they included pregnant women who were at least 20 weeks gestation and reported qualitative data from women on assessing FMs in pregnancy. MEDLINE, CINAHL, EMBASE, PsycINFO and Social Science Citation Index, from inception to July 2020, were searched. The methodological quality of included studies was assessed by at least two reviewers using an Evidence for Policy and Practice Information (EPPI)-Centre quality assessment tool. Data synthesis, using the Thomas and Harden framework, involved line by line coding of extracted data, establishing descriptive themes, and determining analytical themes. Confidence in the findings was assessed using GRADE CER-Qual.
Results
Nine studies, involving 2193 women, were included in the review. The methodological quality of the studies was overall generally high. The synthesis revealed three dominant themes, and seven sub-themes that reflected women’s perspectives of assessing FMs in pregnancy. These were; 1) How women engage with FMs, with subthemes of informal engagement, formal engagement, and strategies to stimulate FMs; 2) ‘ … like a feather inside my belly’ - articulating and describing FMs, with sub-themes of sensations associated with FMs and timing and frequency of FMs; and 3) FMs and help/health seeking, with sub-themes of information sources and interacting with healthcare professionals. Confidence in the findings was either high or moderate, although two findings were rated low confidence and one very low.
Conclusion
This qualitative evidence synthesis reveals that women informally engage with FMs during pregnancy. Women commonly adopt strategies to stimulate FMs when concerned. The use of the internet was a common source of obtaining information regarding FMs. Women require better support when contacting healthcare professionals about FMs. As only three of the nine included studies were exclusively qualitative in design, further qualitative studies exploring women’s perspective of assessing FMs in pregnancy are required.
... Fifty-six of these were subsequently excluded for the following reasons; 30 had no qualitative data speci cally on views, experiences or perceptions of assessing FMs, seven were literature reviews, six were letters to journal Editors, three were conference abstracts with insu cient qualitative data to include, two were identi ed as further duplicate reports, two were not in English, two were randomised trials, one included women at less than 20 weeks of pregnancy, one was a cross-over study with insu cient qualitative data to include, one was a poster abstract of an included study, and, for one, we were unable to obtain the full text to accurately assess eligibility. The references, and exclusion reasons for these 56 excluded studies are provided in Additional File 2. This resulted in the inclusion of nine studies across 11 publications [34][35][36][37][38][39][40][41][42][43][44]. Figure 2 illustrates the search and selection process. Table 2 presents the summary characteristics of the included studies. ...
... Table 2 presents the summary characteristics of the included studies. Three studies (four reports) were conducted in Sweden [34,[38][39]42], three in Australia [40,41,43], two in the UK [37,44] and one (two reports) in New Zealand [35,36]. The majority of the studies (n=6) were conducted from 2011 onwards, with one conducted in 1986 [37], and for two, the study dates were not provided [35][36]43]. ...
... Three studies (four reports) were conducted in Sweden [34,[38][39]42], three in Australia [40,41,43], two in the UK [37,44] and one (two reports) in New Zealand [35,36]. The majority of the studies (n=6) were conducted from 2011 onwards, with one conducted in 1986 [37], and for two, the study dates were not provided [35][36]43]. Data collection involved the use of questionnaires with open-ended response options in six studies [34,[37][38][39][40][41]43] and interviews in the remaining three studies [35-36, 42, 44]. ...
Background: Raising awareness of the importance of fetal movements (FMs) and advising women on the appropriate action to take if they experience reduced FMs, is critical for minimising or avoiding adverse perinatal outcomes. To gain insight and understanding of women’s perspectives of assessing FMs in pregnancy, we conducted a qualitative evidence synthesis.
Methods: A qualitative evidence synthesis using thematic synthesis was conducted. Studies were eligible if they included pregnant women who were at least 20 weeks gestation and reported qualitative data from women on assessing FMs in pregnancy. MEDLINE, CINAHL, EMBASE, PsycINFO and Social Science Citation Index, from inception to July 2020, were searched. The methodological quality of included studies was assessed by at least two reviewers using an EPPI-Centre quality assessment tool. Data analysis, using the Thomas and Harden framework, involved line by line coding of extracted data, establishing descriptive themes, and determining analytical themes. Confidence in the findings was assessed using GRADE CER-Qual.
Results: Nine studies, involving 2193 women, were included in the review. The methodological quality of the studies was overall generally high. The synthesis revealed three dominant themes, and seven sub-themes that reflected women’s perspectives of assessing FMs in pregnancy. These were; 1) How women engage with FMs, with subthemes of informal engagement, formal engagement, and strategies to stimulate FMs; 2) ‘…like a feather inside my belly’ - articulating and describing FMs, with sub-themes of sensations associated with FMs and timing and frequency of FMs; and 3) FMs and help/health seeking, with sub-themes of information sources and interacting with healthcare professionals. Confidence in the findings was either high or moderate, although two findings were rated low confidence and one very low.
Conclusion: This qualitative evidence synthesis reveals that women informally engage with FMs during pregnancy. Women commonly adopt strategies to stimulate FMs when concerned. The use of the internet was a common source of obtaining information regarding FMS. Women require better support when contacting healthcare professionals about FMs. As only three of the nine included studies were exclusively qualitative in design, further qualitative studies exploring women’s perspective of assessing FMs in pregnancy are required.
... [43,44]. Some pregnant women have interpreted fetal movement as a fetal demand for food, prompting them to wake up and eat [32,45]. ...
Evidence from women working night shifts during pregnancy indicates that circadian rhythm disruption has the potential to adversely influence pregnancy outcomes. In the general population, chronodisruption with the potential to affect pregnancy outcomes may also be seen in those with high energy intakes in the evening or at night. However, maternal night eating during pregnancy remains understudied. This narrative review provides an overview of the prevalence, contributing factors, nutritional aspects and health implications of night eating during pregnancy. We derived evidence based on cross-sectional studies and longitudinal cohorts. Overall, night eating is common during pregnancy, with the estimated prevalence in different populations ranging from 15% to 45%. The modern lifestyle and the presence of pregnancy symptoms contribute to night eating during pregnancy, which is likely to coexist and may interact with multiple undesirable lifestyle behaviors. Unfavorable nutritional characteristics associated with night eating have the potential to induce aberrant circadian rhythms in pregnant women, resulting in adverse metabolic and pregnancy outcomes. More research, particularly intervention studies, are needed to provide more definite information on the implications of night eating for mother-offspring health.
... There is no agreed objective definition of reduced fetal movement due to nature of the movements can change as pregnancy advances , the a subjective perception of a decreases fetal movement being the most significant definition clinically [5]. ...
... A small qualitative descriptive study of maternal perception of fetal movements in the third trimester reported that some women described increased fetal movement when they were hungry which they interpreted as a fetal demand for food. Participants also reported fetal quiescence following meals, which some interpreted as fetal satiation [28]. ...
Background:
Maternal reports of decreased fetal movements are associated with adverse pregnancy outcome, but there are conflicting data about perception of fetal movements in women with obesity.
Aim:
To compare perceived fetal movements in women with obesity (body mass index [BMI] ≥30 kg/m2) and women with normal BMI (<25 kg/m2).
Material and methods:
Data from two separate pregnancy studies were used for this analysis; the Healthy Mums and Babies (HUMBA) trial, which recruited women with obesity and the Multicentre Stillbirth Study (MCSS), which recruited women from a general obstetric population. Fetal movement data were collected using identical interviewer-administered questionnaire in each study. We compared fetal movement strength, frequency and pattern between HUMBA and MCSS women with obesity and MCSS women with normal BMI.
Results:
Participants were 233 women with obesity and 149 with normal BMI. Mean (SD) gestation at interview was similar between groups (36.9 [2.2] vs 36.6 [0.9], P = 0.06). Perceived fetal movement strength and frequency did not differ between groups. In both women with obesity and normal BMI, a diurnal fetal movement pattern was present, with the majority reporting strong or moderate movements in the evening (88.7% vs 99.3%) and at night-time (92.1% vs 93.1%). Women with obesity, were more likely to report strong fetal movements when hungry (29.1% vs 17.7%, P = 0.001) and quiet fetal movements after eating (47.4% vs 32.0%, P = 0.001).
Conclusions:
In women with obesity compared to normal BMI, strength and frequency of fetal movements were similar, although patterns were altered in relation to maternal meals.
... A secondary aim was to describe any variation in perceived fetal movements at term as compared to early third trimester. We also sought to explore maternal report of variation in fetal movement strength in relation to factors that are commonly believed to provide a stimulus to fetal movement such as noise, touch, and ingestion of food and drinks [25]. ...
Background and objectives:
Encouraging awareness of fetal movements is a common strategy used to prevent stillbirths. Information provided to pregnant women about fetal movements is inconsistent perhaps due to limited knowledge about normal fetal movement patterns in healthy pregnancies. We aimed to describe maternally perceived fetal movement strength, frequency, and pattern in late pregnancy in women with subsequent normal outcomes.
Methods:
Participants were ≥28 weeks' gestation, with a non-anomalous, singleton pregnancy who had been randomly selected from hospital booking lists and had consented to participate. Fetal movement data was gathered during pregnancy via a questionnaire administered face-to-face by research midwives. Participants remained eligible for the study if they subsequently gave birth to a live, appropriate-for-gestational-age baby at ≥37 weeks.
Results:
Participants were 274 women, with normal pregnancy outcomes. The majority (59.3%, n = 162) of women reported during antenatal interview that the strength of fetal movements had increased in the preceding two weeks. Strong fetal movements were felt by most women in the evening (72.8%, n = 195) and at night-time including bedtime (74.5%, n = 199). The perception of fetal hiccups was also reported by most women (78.8%). Women were more likely to perceive moderate or strong fetal movements when sitting quietly compared with other activities such as having a cold drink or eating.
Conclusions:
Our data support informing women in the third trimester that as pregnancy advances it is normal to perceive increasingly strong movement, episodes of movements that are more vigorous than usual, fetal hiccups, and a diurnal pattern involving strong fetal movement in the evening. This information may help pregnant women to better characterise normal fetal movement and appropriately seek review when concerned about fetal movements. Care providers should be responsive to concerns about decreased fetal movements in the evening, as this is unusual.
... [4] Movements are better felt around maternal mealtimes. [5] There is no evidence that "any absolute definition for reduced FMs" is of greater value than the "subjective maternal perception of reduced FMs" in the detection of fetal compromise or fetal death. [6] Around 50% of the mothers perceive a gradual reduction in FMs days before intrauterine fetal death (IUFD). ...
Background: Fetal movement (FM) monitoring by the expectant mother is a noninvasive and inexpensive method to detect a fetus at risk. In spite of using available methods, stillbirths continue to occur; hence, there is a need for newer methods.
Methods: In this prospective case–control study, 500 booked uncomplicated singleton antenatal mothers were introduced to a specially designed daily FM count (DFMC) chart at 24 weeks of gestation. The ultrasonography (USG) evaluation for all the women was conducted before the beginning of the study. Women were advised to record FMs for an hour after breakfast, after lunch, and after dinner. If the FMs felt were less than five in the first hour, they were advised to continue recording the movements in the subsequent hours. Women were advised to consider “FM diminished” and report to the doctor when they persistently perceived less than five movements/hour for 6 h. Five hundred similarly booked antenatal mothers, who were not given DFMC charts, formed the control group. The number of mothers who reported diminished FM, number of intrauterine fetal deaths (IUFDs), and the number of meconium-stained liquor at delivery in the subgroups of women with abnormal cardiotocography (CTG) and biophysical profile (BPP) were recorded in both groups and compared.
Results: The number of mothers who reported diminished FM in cases was 39 (7.8%) and in controls was 15 (3%). The number of IUFDs in cases were 2 (0.4%) and in controls were 9 (1.8%). The number of fetuses with abnormal CTG and BPP in cases was 15 (3%) and in controls was 3 (0.6%). The number of fetuses with meconium-stained liquor in subgroup of women with abnormal CTG and BPP in cases was 11 (73%) and in controls was 3 (100%). Statistically significant differences were observed between cases and controls with P < 0.005, favoring the use of new DFMC charts.
Conclusion: Fetal monitoring with the new DFMC charts by every mother from 24 weeks onward improves maternal awareness about FMs and helps detect fetuses at risk for IUD, leading to reduction in stillbirths.
... Environmental stimuli, including: touch, music or loud voices, and maternal hunger or eating promoted movement for some women. 40 Increased fetal movement later in the day and in seated positions was universally reported. These fetal movement properties came to be an expected part of the baby's movement pattern and were spontaneously monitored by women in an individualised self-assessment that was qualitative in nature. ...
Problem:
Decreased fetal movements is a common reason for unscheduled antenatal assessment and is associated with adverse pregnancy outcome.
Background:
Fetal movement counting has not been proven to reduce stillbirths in high-quality studies.
Aims:
The aim was to explore a qualitative account of fetal movements in the third trimester as perceived by pregnant women themselves.
Methods:
Using qualitative descriptive methodology, interviews were conducted with 19 women experiencing an uncomplicated first pregnancy, at two timepoints in their third trimester. Interview transcripts were later analysed using qualitative content analysis.
Findings:
Pregnant women described a sustained increase in strength, frequency and variation in types of fetal movements from quickening until 28-32 weeks. Patterns of fetal movement were consistently described as involving increased movement later in the day and as having an inverse relationship to the women's own activity and rest. At term, the most notable feature was increased strength. Kicking and jolting movements decreased whilst pushing and rolling movements increased.
Discussion:
Maternal descriptions of fetal activity in this study were consistent with other qualitative studies and with ultrasound studies of fetal development.
Conclusion:
Pregnant women observe a complex range of fetal movement patterns, actions and responses that are likely to be consistent with normal development. Maternal perception of a qualitative change in fetal movements may be clinically important and should take precedence over any numeric definition of decreased fetal movement. Midwives may inform women that it is normal to perceive more fetal movement in the evening and increasingly strong movements as pregnancy advances.
