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Maternal perception of fetal movements has been widely used for the evaluation of the fetal wellbeing, based on the observation that pregnant women consistently noting regular fetal movement are associated with better pregnancy outcome, and by contrast, in which maternal perception of reduced fetal movements is frequently accompanied with a significant increase of adverse perinatal outcomes, such as an increased risk of intrauterine fetal death, fetal growth restriction, preterm labor, oligohydramnios, and fetal abnormality. Although the decrease and/or absence of maternal perception of fetal movement does not always indicate the worst perinatal outcomes, many reports have shown that more than half of pregnant women might find that fetal movements gradually decrease and finally are absent several days before the occurrence of intrauterine fetal death. In fact, it may be a most common practice to introduce fetal movement counting when there is already suspected fetal compromise. Taken together, it suggests that fetal movement might be an important issue for pregnant women, and one of the most important parts during the prenatal care. Therefore, education of women about the perception of fetal movement is important when women were found that they have a baby. In the August issue of the Journal of the Chinese Medical Association, Drs. Akkaya H and Buke B published a very interesting article addressing this topic, entitled “ a frequently asked question: Is it normal not to feel my baby's movements yet?”. They focused on the early-stage pregnant women (between 16 gestational weeks and 20 gestational weeks), by conducting a prospective comparative study to evaluate 423 pregnant women who reported the first maternal perception of fetal movements and the authors separated them into three groups based on early perception ( 25th the percentile, defined as at the 16 gestational weeks, n 1⁄4 152); average perception (>25th and <75th percentile, defined as at the 17 gestational weeks, n 1⁄4 141); and late perception ( 75th percentile, defined as at the 19 gestational weeks, n 1⁄4 130). The authors found that higher parity, advanced maternal age, higher levels of education, and lower body mass index (BMI) as well as placental site located on the posterior uterine wall are associated with early perception of fetal movement in the pregnant women. This study is impressive and of value; however, some results are confusing and need further verification. First, in regards to maternal age, the authors wrote the following positive findings, including a statistically significant

Perception of fetal movement in the pregnant women