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

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

American journal of perinatology Pub Date : 2024-12-21 DOI:10.1055/a-2486-7642

Jia Jennifer Ding, Olivia Paoletti, Jennifer Culhane, Lisbet Lundsberg, Caitlin Partridge, Sarah N Cross

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引用次数: 0

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..

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足月胎儿运动减少与分娩与准产管理相关的产妇特征和妊娠结局。

目的：本研究旨在比较经评估为胎动减少（DFM）的足月患者的产妇特征和妊娠结局。研究设计：回顾性队列研究，研究对象为2015年至2023年在一家大型医院系统内分娩并接受DFM评估的足月患者。根据DFM评估至分娩入院的时间将患者分为三组：(1)48 h。进行双变量比较和多项逻辑回归来评估哪些产妇特征与立即分娩（48小时潜伏期）相关，并比较分娩和新生儿结局。结果：在2015例患者中，两组之间存在显著的社会人口学和临床差异。调整后，非商业保险、妊娠期高血压、分娩时体重指数(BMI)≥30 kg/m2与48小时入院几率降低相关。没有死产或新生儿死亡病例，分娩或新生儿结局没有差异。结论：在足月DFM患者中，入院48小时的患者存在显著的社会人口学和临床差异，尽管分娩和新生儿结局相似。·有非商业保险、孕期高血压、分娩时BMI≥30 kg/m2与足月出现DFM后48小时内入院几率降低相关。·在这组足月出现DFM的患者中，没有死产或新生儿死亡的病例。·在这组足月出现DFM的患者中，从就诊到入院分娩的时间分层，分娩或新生儿结局没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.