Mobile applications providing guidance about decreased fetal movement: Review and content analysis

Background: Maternal perception of decreased fetal movement has clinical significance as a predictor of pregnancies at risk of adverse outcomes, including stillbirth. Increasingly, women are using mobile applications ("apps") to access information during the antenatal period. Little is known about how apps intended for use during pregnancy guide women to address fetal movement concerns. Objective: To explore information about decreased fetal movement provided through mobile apps intended for use during pregnancy. Methods: A systematic review framework was applied to the search, screening, and assessment of mobile apps. A sample of apps were downloaded in December 2016 that met inclusion criteria for accessibility, reach, relevance and quality. Data extraction was performed independently by two reviewers in January 2017. A quantitative and qualitative approach was taken to analyse data and present results. Findings: All 24 apps in the sample mentioned decreased fetal movement, but few explicitly link decreased fetal movement to stillbirth or other specific adverse outcomes. There is substantial variability in guidance for fetal movement monitoring. One-quarter of apps recommend consumption of food or drink to stimulate fetal movement, two-thirds of apps recommend "kick counting", and one-third offer a kick "counter". Conclusion: This review is the first to assess information about decreased fetal movement available in mobile apps intended for download by pregnant women. Across the sample, this review identifies a lack of evidence-based clinical advice to guide women experiencing decreased fetal movement. As an antenatal education tool used by millions of women, accurate content about fetal movement is essential. (C) 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.