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July 13, 2021

Delivery Before 39 Weeks’ Gestation for Suspected Fetal Growth Restriction: More Harm Than Good?

Author Affiliations
  • 1University of Utah, Salt Lake City
JAMA. 2021;326(2):135-136. doi:10.1001/jama.2021.8381

In this issue of JAMA, Selvaratnam and colleagues1 use an innovative approach to show that iatrogenic delivery (defined as early induction of labor or cesarean delivery prior to labor) for suspected fetal growth restriction (FGR) may be associated with relatively poorer school outcomes. In the birth population of 705 937 infants born at 32 weeks’ gestation or greater in Victoria, Australia, between 2003 and 2013, infants who were severely small for gestational age (SGA) (birth weight <3rd percentile) and who were iatrogenically delivered for suspected FGR, compared with infants with severe SGA who were not suspected of having FGR, had a significantly increased risk of poor developmental outcome at school entry (16.2% vs 12.7%; adjusted odds ratio, 1.36 [95% CI, 1.07-1.74]) and poorer educational outcomes in grades 3, 5, and 7. In contrast, there was no significant difference between infants with normal birth weight (birth weight ≥10th percentile) delivered for suspected FGR and those not suspected of having FGR in risk of poor developmental outcome at school entry (8.6% vs 8.1%; adjusted odds ratio, 1.17 [95% CI, 0.95-1.45]) or educational outcomes in grade 3, 5, or 7.