Bronovo Hospital, The Hague, The Netherlands.
Am J Obstet Gynecol. 2012 Apr;206(4):344.e1-7. doi: 10.1016/j.ajog.2012.01.015. Epub 2012 Jan 13.
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).
We used data from the DIGITAT. For each neonate, we calculated the MAIN score, a validated outcome scale.
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.
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.
足月胎儿宫内生长受限干预试验（DIGITAT）比较了疑似宫内生长受限（IUGR）足月时引产与期待治疗的效果。在此子分析中，我们根据新生儿发病率评估指标（MAIN）报告了两种策略之间的新生儿发病率。
我们使用了 DIGITAT 的数据。对于每个新生儿，我们计算了 MAIN 评分，这是一种经过验证的结局评分。
两组新生儿 MAIN 评分的平均值或 MAIN 发病率类别均无差异。我们发现，两组中，与 36 周和 37 周相比，38 周时新生儿入院率较低。
IUGR 足月时，无论采用引产还是期待治疗，新生儿发病率相当且相对较轻。然而，38 周后新生儿入院率较低，因此，如果考虑引产以预防可能的死产，在密切监测下，合理的做法是延迟至 38 周。
