The Growth Restriction Intervention Trial: long-term outcomes in a randomized trial of timing of delivery in fetal growth restriction.
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.


METHODS
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.


CONCLUSIONS
Clinically significant differences between immediate and deferred delivery were not found.
Department of Community Health Sciences, University of Nottingham, UK. dawn-marie.walker@nottingham.ac.uk
Dawn-Marie
DM
Walker
Neil
N
Marlow
Lisa
L
Upstone
Harriet
H
Gross
Janet
J
Hornbuckle
Andy
A
Vail
Dieter
D
Wolke
Jim G
JG
Thornton
D000293:Adolescent; D000465:Algorithms; D001499:Bayes Theorem; D002648:Child; D002657:Child Development; D003071:Cognition; D036861:Delivery, Obstetric / Q000401:mortality; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D005317:Fetal Growth Retardation / Q000401:mortality; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007802:Language; D008297:Male; D009426:Netherlands; D011247:Pregnancy; D017524:Slovenia; D017741:Survivors; D013997:Time Factors; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000000981:diagnostic imaging; D006113:United Kingdom