title: Pregnancy Outcome in Women with Decreased Sensation of Fetal Movements at Term According to Parity.
abstract: 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.
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Shmueli
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Hadar
mesh_terms: D000328:Adult; D001034:Apgar Score; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005313:Fetal Death; D005324:Fetal Movement; D006801:Humans; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology*; D047929:Term Birth; D055815:Young Adult
keywords: decreased fetal movements; multiparity; nulliparity; perinatal outcome; pregnancy outcome