Maternal Characteristics and Pregnancy Outcomes Associated with Delivery versus Expectant Management following Decreased Fetal Movement at Term

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

Publication History

Received: 31 July 2024

Accepted: 25 November 2024

Article published online:
21 December 2024

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