Objective: This study aimed to compare maternal characteristics and pregnancy outcomes between term patients evaluated for decreased fetal movement (DFM) who were delivered versus expectantly managed.
Study design: Retrospective cohort study of term patients delivering within a large hospital system from 2015 to 2023 who were evaluated for DFM. Patients were classified into three groups based on the time between evaluation for DFM and delivery admission: (1) <24 hours, (2) 24-48 hours, (3) >48 hours. Bivariate comparisons and multinomial logistic regression were performed to evaluate which maternal characteristics were associated with immediate delivery (<24 and 24-48 hours latency) as compared with expectant management (>48 hours latency) as well as to compare delivery and neonatal outcomes.
Results: Of 2,015 patients, significant sociodemographic and clinical variations were noted between groups. Following adjustment, noncommercial insurance, hypertension in pregnancy, and body mass index (BMI) ≥30 kg/m2 at delivery were associated with reduced odds of admission <24 and 24-48 hours as compared with >48 hours. There were no cases of stillbirth or neonatal demise and there were no differences in delivery or neonatal outcomes.
Conclusion: Among patients with DFM at term, there are significant sociodemographic and clinical variations between those admitted for <24, 24-48, and >48 hours, though delivery and neonatal outcomes were similar.
Key points: · Having noncommercial insurance, hypertension in pregnancy, and BMI ≥30 kg/m2 at delivery were associated with reduced odds of admission within <24 and 24-48 hours as compared with >48 hours after presenting with DFM at term.. · There were no cases of stillbirth or neonatal demise among this cohort of patients presenting with DFM at term.. · There were no differences in delivery or neonatal outcomes among this cohort of patients presenting with DFM at term as stratified by timing from presentation to admission for delivery..
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