Department of Community Health Sciences, University of Nottingham, UK.
Am J Obstet Gynecol. 2011 Jan;204(1):34.e1-9. doi: 10.1016/j.ajog.2010.09.019. Epub 2010 Nov 5.
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.
Children were tested with standardized school-based evaluations of cognition, language, motor performance, and behavior. Analysis and interpretation were Bayesian.
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.
Clinically significant differences between immediate and deferred delivery were not found.
生长受限干预试验发现，在存在生长受限且产科医生不确定是否分娩的情况下，当胎儿健康受损的迹象出现时，立即或延迟分娩与整体死亡率或 2 年结局相关，差异不大。由于幼儿评估的预测价值有限，我们重新评估了这些评估。
儿童接受了基于标准化学校的认知、语言、运动表现和行为评估。分析和解释采用贝叶斯方法。
在 376 名婴儿中，302 名（80%）有已知结局：死亡或在 6-13 岁时进行评估。立即组和延迟组死亡或严重残疾的儿童数量分别为 21 名（14%）和 25 名（17%）。在幸存者中，认知评分的平均值（SD）分别为 95（15）和 96（14）；运动评分分别为 8.9（7.0）和 8.7（6.7）；父母评估的行为评分分别为 10.5（7.1）和 10.5（6.9）。
立即和延迟分娩之间没有发现临床意义上的显著差异。
