{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:38:54Z","timestamp":1782866334462,"version":"3.54.5"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>\n            Objective\u2003This study was conducted to determine the difference in the number of pregnancies that would qualify for outpatient fetal testing between our current academic practice and that of the 2021 American College of Obstetricians and Gynecologists (ACOG) antepartum recommendations.<\/jats:p><jats:p>\n            Study Design\u2003We performed a retrospective study of all pregnancies that delivered and received prenatal care at our institution between January 1, 2019, and May 31, 2021. The timing and amount of outpatient antepartum testing was determined for each patient. Our current antepartum testing guidelines (clinic protocol) were compared with the 2021 ACOG recommendations (ACOG protocol). Statistical analysis was performed with descriptive statistics and z scoring to compare the total amount of antepartum testing utilized with each protocol.<\/jats:p><jats:p>\n            Results\u2003A total of 1,335 pregnancies were included in the study. With the ACOG protocol, an additional 310 (23.2%) of pregnancies would qualify for antepartum testing (57.8% with ACOG protocol vs. 34.6% with clinic protocol). Most of the increased testing was due to maternal age with additional risk factors, hypertensive disorders, diabetes, prepregnancy body mass index \u2265 35, and complex fetal anomalies or aneuploidies. Overall, the ACOG protocol would require an additional 570 antepartum tests (z-score\u2009=\u20094.04, p\u2009=\u20090.000005) over the study period, which is equivalent to 19 additional tests per month and 5 per week. Only nine stillbirths occurred during this time, of which two would have had antepartum testing with both protocols, one would have only had testing per ACOG, and two would have had testing individualized per ACOG.<\/jats:p><jats:p>\n            Conclusion\u2003More pregnancies would require outpatient antenatal testing with adoption of the ACOG protocol. A 23% increase in testing would equate to five additional antepartum tests per week. Although this study cannot assess the clinical impact of additional testing, minimal scheduling resources are needed to accommodate this increase.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0042-1759706","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T23:55:15Z","timestamp":1670284515000},"page":"711-717","source":"Crossref","is-referenced-by-count":4,"title":["Implementing American College of Obstetricians and Gynecologists Outpatient Antepartum Testing Recommendations: Can Your Clinic Handle It?"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1686-5303","authenticated-orcid":false,"given":"Michelle N.","family":"Lende","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3656-7124","authenticated-orcid":false,"given":"Tara A.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,12,5]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"e177","DOI":"10.1097\/AOG.0000000000004407","article-title":"Indications for outpatient antenatal fetal surveillance. 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Obstetric Care Consensus #10: Management of Stillbirth","volume":"222","author":"American College of Obstetricians and Gynecologists","year":"2020","journal-title":"Am J Obstet Gynecol"},{"issue":"12","key":"ref12","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1377\/hlthaff.2019.00805","article-title":"Rural-urban differences in severe maternal morbidity and mortality in the US, 2007-15","volume":"38","author":"K B Kozhimannil","year":"2019","journal-title":"Health Aff (Millwood)"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/1472-6963-11-147","article-title":"Distance matters: a population based study examining access to maternity services for rural women","volume":"11","author":"S Grzybowski","year":"2011","journal-title":"BMC Health Serv Res"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/00006254-198603000-00001","article-title":"Assessing the diagnostic accuracy and efficacy of selected antepartum fetal surveillance techniques","volume":"41","author":"S B Thacker","year":"1986","journal-title":"Obstet Gynecol Surv"},{"issue":"01","key":"ref15","first-page":"CD005122","article-title":"Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing","volume":"1","author":"D Devane","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"02","key":"ref16","first-page":"271","article-title":"The case for intervention bias in the practice of medicine","volume":"86","author":"A J Foy","year":"2013","journal-title":"Yale J Biol Med"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1097\/AOG.0000000000002967","article-title":"Antepartum testing for the prevention of stillbirth: where do we go from here?","volume":"132","author":"G J Johnson","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1097\/AOG.0b013e318197bd8a","article-title":"Antenatal testing-a reevaluation: executive summary of a Eunice Kennedy Shriver National Institute of Child Health and Human Development workshop","volume":"113","author":"C Signore","year":"2009","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/AOG.0000000000003614","article-title":"Risk of stillbirth for fetuses with specific birth defects","volume":"135","author":"D Heinke","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"18","key":"ref20","doi-asserted-by":"crossref","first-page":"2985","DOI":"10.1080\/14767058.2018.1453799","article-title":"Obstetric and perinatal outcomes in pregnancies with isolated foetal congenital heart abnormalities","volume":"32","author":"C Liu","year":"2019","journal-title":"J Matern Fetal Neonatal Med"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1759706.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:37:54Z","timestamp":1682383074000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1759706"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,5]]},"references-count":20,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2023,4,24]]},"published-print":{"date-parts":[[2023,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1759706","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,5]]}}}