Maternal perception of fetal movements: onset and associated factors

Objectives The purpose of this study was to determine the onset of fetal movements' perception and to identify parameters that affect this timing. Methods This was a prospective cohort study including singleton pregnancies that attended routine prenatal care, in a tertiary care center, in northern Greece, between January 2020 and July 2021. We collected data on medical and obstetric history, and invited women to record the time that they perceived the fetal movements for the first time, that being the primary outcome of the study. Furthermore, we studied the associations between this timing and several obstetric and sociodemographic parameters. Results In total, 2,009 women participated in the study. The mean gestational age at first perception of fetal movements was 19 weeks (+/- 1.5). This ranged from as early as 14(+0)-14(+6) weeks (0.1%) to 24(+0)-24(+6) weeks (0.1%). The majority of women (73.3%) reported initial perception of fetal movements between 18(+0) and 20(+6) weeks. Following multivariate logistic regression analysis, we found that nulliparity (OR: 2.607; 95% CI: 1.876-3.622; p<0.001), anterior placental position (OR: 1.918; 95% CI: 1.575-2.336; p<0.001), increasing body mass index (OR: 1.063; 95% CI: 1.040-1.088; p=0.001) and advancing maternal age (OR: 1.062; 95% CI: 1.040-1.084; p<0.001) were associated with a delayed perception of fetal movements. Multiparous women reported the onset of fetal movements almost one week earlier on average (18.6 +/- 1.4 weeks) compared to nulliparous (19.4 +/- 1.4 weeks; MD: 0.843; 95% CI: 0.718-0.968; p<0.001). Conclusions The onset of maternal perception of fetal movements is around 19 weeks and this timing may be delayed by higher maternal age, higher body mass index, nulliparity and anterior placental position.