Neonatal morbidity after induction vs expectant monitoring in intrauterine growth restriction at term: A subanalysis of the DIGITAT RCT

Kim E. Boers, Linda Van Wyk, Joris A.M. Van Der Post, Anneke Kwee, Maria G. Van Pampus, Marc E.A. Spaanderdam, Johannes J. Duvekot, Henk A. Bremer, Friso M.C. Delemarre, Kitty W.M. Bloemenkamp, Christianne J.M. De Groot, Christine Willekes, Monique Rijken, Frans J.M.E. Roumen, Jim G. Thornton, Jan M.M. Van Lith, Ben W.J. Mol, Saskia Le Cessie, Sicco A. Scherjon

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Abstract

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.

Original languageEnglish
Pages (from-to)344.e1-344.e7
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume206
Issue number4
DOIs
Publication statusPublished - 1 Jan 2012
Externally publishedYes

Keywords

  • Disproportionate Intrauterine Growth Intervention Trial at Term
  • induction of labor
  • intrauterine growth restriction at term
  • Morbidity Assessment Index for Newborns score
  • neonatal morbidity

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