title: Late preterm and early term: when to induce a growth restricted fetus? A population-based study.
abstract: OBJECTIVE
  (1) Compare fetal and neonatal morbidity and mortality associated with induction of labor (IOL) versus expectant management (EM) in women with isolated fetal growth restriction (FGR) between 340/7and 386/7weeks; (2) Determine optimal gestational age for delivery of such fetuses.
  
  
  METHODS
  A retrospective population based cohort study of 2232 parturients with isolated FGR, including two groups: (1) IOL (n = 1428); 2) EM (n = 804).
  
  
  RESULTS
  IOL group had a lower stillbirth and neonatal death rates (p = .042, p < .001), higher 1 and 5 min Apgar scores and a higher vaginal delivery rate compared to the EM group. In the late preterm period, EM was associated with increased rate of low 1 and 5 min Apgar scores, nonreassuring fetal heart rate tracing (NRFHR), stillbirth and neonatal death rate (p = .001, p = .039). In the early term cohort, EM was associated with a higher rate of NRFHR and low 1 min Apgar scores (p = .003, p = .002). IOL at 37 weeks protected from stillbirth but not from adverse composite neonatal outcomes.
  
  
  CONCLUSIONS
  IOL of FGR fetuses at 37 weeks had a protective effect against stillbirth. In addition, at late preterm, it is associated with lower rates of stillbirth, neonatal death, and NRFHR.
authors.affiliation: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Alex
authors.initials: A
authors.lastname: Rabinovich
authors.affiliation: b Department of Epidemiology, School of Medicine, Faculty of Health Sciences , Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Tehila
authors.initials: T
authors.lastname: Tsemach
authors.affiliation: b Department of Epidemiology, School of Medicine, Faculty of Health Sciences , Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Lena
authors.initials: L
authors.lastname: Novack
authors.affiliation: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Mazor
authors.affiliation: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Rafaeli-Yehudai
authors.affiliation: c Department of Neonatology , Soroka University Medical Center, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Orna
authors.initials: O
authors.lastname: Staretz-Chacham
authors.affiliation: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Ruth
authors.initials: R
authors.lastname: Beer-Weisel
authors.affiliation: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Vered
authors.initials: V
authors.lastname: Klaitman-Mayer
authors.affiliation: d Department of Obstetrics and Gynecology , Fondazione MBBM, San Gerardo Hospital , Monza , Italy.
authors.forename: Salvatore A
authors.initials: SA
authors.lastname: Mastrolia
authors.affiliation: a Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Offer
authors.initials: O
authors.lastname: Erez
mesh_terms: D000328:Adult; D001034:Apgar Score; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005316:Fetal Distress / Q000517:prevention & control*; D005317:Fetal Growth Retardation; D005865:Gestational Age; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D008423:Maternal Age; D010298:Parity; D066087:Perinatal Death / Q000517:prevention & control*; D011247:Pregnancy; D047928:Premature Birth; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*
keywords: Fetal growth restriction; early term; expectant management; induction of labor; late preterm; perinatal mortality