NEW YORK (Reuters Health) – Whether delivery is immediate of deferred when fetal health is compromised by growth restriction appears to make no difference to outcomes at school age, according to a report in the American Journal of Obstetrics & Gynecology published online November 9.

The findings come from a follow-up of the Growth Restriction Intervention Trial, in which early delivery to preempt hypoxia was compared with delayed delivery (by an average of 4 days) to gain maturity in cases of fetal growth restriction. The current study assessed surviving offspring at a median of 9 years of age, using standardized tests of cognition, language, motor performance and behavior.

“Outcome was known for 302/376 (80%) children of mothers entered into the study and for 78% (269/ 343) survivors,” Dr. Dawn-Marie Walker, of the University of Nottingham, UK, and colleagues report.

The percentage of children known to have died or were severely disabled was similar in the immediate and deferred groups: 14% vs 17%, respectively.

Among survivors, mean cognition scores were 95 and 96 in the two groups respectively. Corresponding scores were 8.9 vs 8.7 for motor performance, and 10.5 vs 10.5 for parent-assessed behavior.

The authors say the results show essentially no measurable differences in motor or intellectual disabilities between the two groups. “This is despite the considerable potential for damage from both arms of the trial,” they note.

Differences in stillbirths and neonatal deaths in the two groups indicated that damage did occur. However, Dr. Walker and colleagues conclude, “The lack of difference in outcomes at 6-9 years of age indicates that such damage is largely balanced out, and it is possible that the plasticity of the developing brain overcame any imbalances that remained.”

Am J Obstet Gynecol 2010.