586 Decreased fetal movement and anterior placentation: a case control study

Abstract

Decreased fetal movement (DFM) is a common obstetrical complaint, with an incidence of up to 16% of pregnancies. DFM is often attributed to anterior placentation, however, there is limited data to support this belief. There are no case control studies or studies performed in the United States which address this relationship. This was a case control study of patients who presented to Stamford Hospital with DFM from January 2017 to December 2017. The control group included patients who presented for delivery during this time. Exclusion criteria included presentation prior to 24 weeks gestational age, multi-fetal gestation, and intrauterine fetal demise. Variables collected were placentation, age, parity, gestational age, fetal presentation, BMI, and presence of hypertensive or diabetic disorder. Cohorts were matched by BMI and parity. Discrete variables were analyzed with chi-square statistics and continuous variables were analyzed with independent t-test. Propensity score matching was conducted using the nearest neighbor matching criteria in ‘R.’ Logistic regression was used to calculate adjusted odds ratios. 123 patients presented with DFM and 127 control patients were identified. 112 patients were matched in each group. In the DFM group, 56 (58.3%) had an anterior placenta, compared with 33 (35.1%) in the control group (p=0.001). Patients that presented with DFM were 2.9 times as likely to have an anterior placenta (CI 1.5-5.5). Average maternal age in the DFM group was 30.7 years, compared with 32.7 years in the control group (p=0.005). Patients that presented with DFM were not at an increased odds of presenting with non-vertex presentation (CI 0.10-1.2). There was also no increased odds of hypertensive or diabetic disorder in the DFM group (CI 0.24-2.95; CI 0.30-2.03). Our study supports that patients who present for decreased fetal movement compared with matched controls are at an increased odds of having an anterior placenta. These patients are also younger. There is no increased odds of non-vertex presentation or of having a hypertensive or diabetic disorder.