Neonatal morbidity after induction vs expectant monitoring in intrauterine growth restriction at term: a subanalysis of the DIGITAT RCT - 30/03/12
, Linda van Wyk, MD a, Joris A.M. van der Post, MD, PhD d, Anneke Kwee, MD, PhD g, Maria G. van Pampus, MD, PhD h, Marc E.A. Spaanderdam, MD, PhD i, Johannes J. Duvekot, MD, PhD j, Henk A. Bremer, MD, PhD k, Friso M.C. Delemarre, MD, PhD l, Kitty W.M. Bloemenkamp, MD, PhD a, Christianne J.M. de Groot, MD, PhD e, Christine Willekes, MD, PhD m, Monique Rijken, MD, PhD a, Frans J.M.E. Roumen, MD, PhD n, Jim G. Thornton, MD, FRCOG o, Jan M.M. van Lith, MD, PhD a, Ben W.J. Mol, MD, PhD d, f, Saskia le Cessie, PhD a, Sicco A. Scherjon, MD, PhD bDIGITAT Study Group
Reprints: Kim E. Boers, MD, Department of Obstetrics and Gynecology, Bronovo Hospital, Bronovolaan 5, 2597AX The Hague, The NetherlandsRésumé |
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.
Le texte complet de cet article est disponible en PDF.Key words : Disproportionate Intrauterine Growth Intervention Trial at Term, induction of labor, intrauterine growth restriction at term, Morbidity Assessment Index for Newborns score, neonatal morbidity
Plan
| This study was supported by ZonMw, The Netherlands Organization for Health Research and Development health care efficiency program. |
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| The authors report no conflict of interest. |
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| Cite this article as: Boers KE, van Wyk L, van der Post JAM, et al. Neonatal morbidity after induction vs expectant monitoring in intrauterine growth restriction at term: a subanalysis of the DIGITAT RCT. Am J Obstet Gynecol 2012;206:344.e1-7. |
Vol 206 - N° 4
P. 344.e1-344.e7 - avril 2012 Retour au numéro
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