The growth restriction intervention trial: long-term outcomes in a randomized trial of timing of delivery in fetal growth restriction

Walker, Dawn-Marie, Marlow, Neil, Upstone, Lisa, Gross, Harriet, Hornbuckle, Janet, Vail, Andy, Wolke, Dieter and Thornton, Jim G. (2011) The growth restriction intervention trial: long-term outcomes in a randomized trial of timing of delivery in fetal growth restriction. American Journal of Obstetrics and Gynecology, 204 (1), 34.e1-34.e9. (doi:10.1016/j.ajog.2010.09.019). (PMID:21056403)

Abstract

Objective:
The Growth Restriction Intervention Trial found little difference in overall mortality or 2-year outcomes associated with immediate or deferred delivery following signs of impaired fetal health in the presence of growth restriction when the obstetrician was unsure whether to deliver. Because early childhood assessments have limited predictive value, we reevaluated them.

Study design:
Children were tested with standardized school-based evaluations of cognition, language, motor performance, and behavior. Analysis and interpretation were Bayesian.

Results:
Of 376 babies, 302 (80%) had known outcome: either dead or evaluated at age 6-13 years. Numbers of children dead, or with severe disability: 21 (14%) immediate and 25 (17%) deferred groups. Among survivors, the mean (SD) cognition scores were 95 (15) and 96 (14); motor scores were 8·9 (7·0) and 8·7 (6·7); and parent-assessed behavior scores were 10·5 (7·1) and 10·5 (6·9), respectively, for the 2 groups.

Conclusion:
Clinically significant differences between immediate and deferred delivery were not found.

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Contributors

Author: Dawn-Marie Walker

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