Results of a European study in this week’s issue of THE LANCET suggest that delaying delivery by a few days is as effective as immediate delivery for babies who have experienced fetal trauma. The study also showed that fetuses delivered without delay at 30 weeks or younger had an increased risk of infant disability compared with delayed delivery.
Babies are usually delivered pre-term if they are failing to thrive in utero; however, no study has assessed the effect of altered delivery time on infant mortality or disability. Jim Thornton (University of Nottingham, UK) and colleagues compared the effect of delivering early with delaying birth for as long as possible. 548 pregnant women (with fetal trauma at 24–36 weeks gestation) were recruited by 69 hospitals in 13 European countries. Before birth, 588 babies were randomly assigned to immediate delivery (296) or delayed delivery (292).
Deferred delivery until physicians were certain that delivery was essential resulted in an average 4-day delay in delivery compared with babies born immediately. The overall rate of death was not altered by delay. However, the rate of disability at 2 years of age was 8% for immediate births and 4% for delayed births. Most of the observed difference was in babies younger than 31 weeks of gestation at randomisation: 13% for immediate compared with 5% for delayed deliveries.