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Neonatal
SCHOOL AGE OUTCOME FOLLOWING IMMEDIATE OR DEFERRED DELIVERY FOR FETAL GROWTH RESTRICTION (THE GRIT TRIAL)
  1. DM Walker1,
  2. L Upstone1,
  3. A Vail2,
  4. D Wolke3,
  5. J Thornton1,
  6. N Marlow1
  1. 1School of Human Development, University of Nottingham, Nottingham, UK
  2. 2School of Medicine, University of Manchester, Manchester, UK
  3. 3Department of Psychology and HSRI, University of Warwick, Warwick, UK

Abstract

Background Timing of delivery for fetuses with growth restriction is a balance between fetal harm caused by ongoing hypoxia and that from preterm birth. The Growth Restriction Intervention Trial (GRIT) compared infant outcomes between women who were delivered immediately or delivery deferred. No differences in neonatal or 2 year outcomes were identified between the two groups.

Aim To evaluate children entered into GRIT at early school age to determine if delivery strategy alters cognitive, motor or behavioural outcome.

Methods Children in the UK, Netherlands, Italy, Slovenia and Germany were traced and offered evaluation at 7 years by a psychologist.

Results 453 women (492 infants) were entered into GRIT (77% of total women). No deaths had occurred since 2 years. 7% of women actively declined and outcome status was known for 341 (69%) children. Death or known severe impairment was present in 28 (16%) in deferred delivery arm and 32 (19%) in immediate delivery arm. Scaled scores on assessment (shown in the table) indicated no differences.

View this table:
Table 5

Walker et al Incidence of selected cancers: comparisons within the cohort based on exposure to ionising radiation

Interpretation Within the confines of the GRIT trial, immediate or delayed delivery did not lead to changes in short or long term outcomes.

Funded by MRC, UK.

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