Abstract
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.
Keywords
decreased fetal movement - noncommercial insurance - health disparities
