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Pregnancy Outcome in Women with Decreased Sensation of Fetal Movements at Term According to Parity
Author(s) -
Aviram Amir,
Shmueli Anat,
Hiersch Liran,
Ashwal Eran,
Wiznitzer Ar,
Yogev Yariv,
Hadar Eran
Publication year - 2016
Publication title -
birth
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.233
H-Index - 83
eISSN - 1523-536X
pISSN - 0730-7659
DOI - 10.1111/birt.12205
Subject(s) - medicine , obstetrics , pregnancy , gestation , apgar score , fetus , gynecology , cohort study , retrospective cohort study , genetics , biology
Background Decreased sensation of fetal movements ( DFM ) is a common maternal complaint. Thus, we aimed to evaluate the association between DFM and pregnancy outcome in singleton gestation at term according to parity. Methods A retrospective cohort study of singleton pregnancies at term between 2008 and 2013. Eligibility was limited to women carrying a fetus with no known structural or chromosomal anomalies, at 37+0/7 to 42+0/7 weeks of gestation. Women presenting to the delivery ward with DFM were compared with women without similar complaints. Results Overall, 12,564 nulliparous women and 25,292 multiparous women gave birth during the study period; of them, 300 nulliparous women (2.4%) and 525 multiparous women (2.1%) complained of DFM . For nulliparous women, after adjusting for potential confounders, DFM was associated with antepartum fetal death (aOR 4.6 [95% CI 1.1–19.8]), cesarean delivery ( CD ) (aOR 1.3 [95% CI 1.01–1.8]), 1‐minute Apgar score less than 7 (aOR 2.3 [95% CI 1.5–3.5]) and neonatal seizures (aOR 3.2 [95% CI 1.3–8.2]). For multiparous women, DFM was associated with unscheduled CD (aOR 2.7 [95% CI 1.6–4.6]) and CD indicated by intermediate/abnormal fetal heart rate tracing (aOR 4.8 [95% CI 2.8–8.4]). Conclusions DFM carries different outcomes according to parity. Although for nulliparous women, DFM is associated with increased risk of CD and immediate adverse perinatal outcome, for multiparous women it is associated with increased risk for CD , with no immediate increased risk for adverse perinatal outcome.