TY - JOUR
T1 - Neonatal morbidity after induction vs expectant monitoring in intrauterine growth restriction at term
T2 - A subanalysis of the DIGITAT RCT
AU - Boers, Kim E.
AU - Van Wyk, Linda
AU - Van Der Post, Joris A.M.
AU - Kwee, Anneke
AU - Van Pampus, Maria G.
AU - Spaanderdam, Marc E.A.
AU - Duvekot, Johannes J.
AU - Bremer, Henk A.
AU - Delemarre, Friso M.C.
AU - Bloemenkamp, Kitty W.M.
AU - De Groot, Christianne J.M.
AU - Willekes, Christine
AU - Rijken, Monique
AU - Roumen, Frans J.M.E.
AU - Thornton, Jim G.
AU - Van Lith, Jan M.M.
AU - Mol, Ben W.J.
AU - Le Cessie, Saskia
AU - Scherjon, Sicco A.
N1 - Funding Information:
This study was supported by ZonMw, The Netherlands Organization for Health Research and Development health care efficiency program.
PY - 2012/4
Y1 - 2012/4
N2 - OBJECTIVE: The Disproportionate Intrauterine Growth Intervention Trial at Term (DIGITAT) compared induction of labor and expectant management in suspected intrauterine growth restriction (IUGR) at term. In this subanalysis, we report neonatal morbidity between the policies based on the Morbidity Assessment Index for Newborns (MAIN). STUDY DESIGN: We used data from the DIGITAT. For each neonate, we calculated the MAIN score, a validated outcome scale. RESULTS: There were no differences in mean MAIN scores or in MAIN morbidity categories. We found that neonatal admissions are lower after 38 weeks' gestational age compared with 36 and 37 weeks in both groups. CONCLUSION: The incidence of neonatal morbidity in IUGR at term is comparable and relatively mild either after induction or after an expectant policy. However, neonatal admissions are lower after 38 weeks of pregnancy, so if induction to preempt possible stillbirth is considered, it is reasonable to delay until 38 weeks, provided watchful monitoring.
AB - OBJECTIVE: The Disproportionate Intrauterine Growth Intervention Trial at Term (DIGITAT) compared induction of labor and expectant management in suspected intrauterine growth restriction (IUGR) at term. In this subanalysis, we report neonatal morbidity between the policies based on the Morbidity Assessment Index for Newborns (MAIN). STUDY DESIGN: We used data from the DIGITAT. For each neonate, we calculated the MAIN score, a validated outcome scale. RESULTS: There were no differences in mean MAIN scores or in MAIN morbidity categories. We found that neonatal admissions are lower after 38 weeks' gestational age compared with 36 and 37 weeks in both groups. CONCLUSION: The incidence of neonatal morbidity in IUGR at term is comparable and relatively mild either after induction or after an expectant policy. However, neonatal admissions are lower after 38 weeks of pregnancy, so if induction to preempt possible stillbirth is considered, it is reasonable to delay until 38 weeks, provided watchful monitoring.
KW - Disproportionate Intrauterine Growth Intervention Trial at Term
KW - Morbidity Assessment Index for Newborns score
KW - induction of labor
KW - intrauterine growth restriction at term
KW - neonatal morbidity
UR - http://www.scopus.com/inward/record.url?scp=84859420486&partnerID=8YFLogxK
U2 - 10.1016/j.ajog.2012.01.015
DO - 10.1016/j.ajog.2012.01.015
M3 - Article
C2 - 22342897
AN - SCOPUS:84859420486
SN - 0002-9378
VL - 206
SP - 344.e1-344.e7
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 4
ER -