Brussels, 06 Aug 2004
A pan-European survey, published on 6 August in the Lancet Medical Journal, has found that postponing the birth of a premature baby by just a few days is better for the infant's health.
According to the research, when the risks of waiting or delivering quickly are weighed up, delaying delivery is more likely to prevent brain damage and disability, particularly if the foetus is less than 30 weeks old.
The study, which took place over eight years, was carried out on 588 premature babies in 13 European countries. Some 296 babies were randomised for immediate delivery and 292 were deferred by an average of 4.5 days.
Although the death rates were about the same in the two groups, when it came to brain damage, delaying the delivery appeared to be the better choice.
Indeed, at age two, the disability rate (including cerebral palsy) was eight per cent among babies born immediately and four per cent among the group whose birth was postponed. Most of the difference was seen in babies who were born less than 31 weeks into a pregnancy.
Around 90 per cent of babies born at 28 weeks of gestation survive, stated study author Dr Jim Thornton, a professor of obstetrics and gynaecology at City Hospital in Nottingham, the UK.
Deciding the best time of delivery for a baby that is neither growing nor thriving in the womb can be a difficult decision for doctors because premature babies have a higher risk of suffering from respiratory disorders, cerebral palsy and other problems. At the same time, a delivery that is delayed too long can lead to oxygen deficiency and stillbirth.
The study, however, found that on average, waiting improved the chances of brain development.
'Until now,' said Dr Thornton, 'the point at which [doctors] said the baby is better out than in was based on hunch and intuition. There was never a randomised controlled trial to choose the right time.'
'Hopefully our results will give doctors better information to make those crucial decisions,' he added. To read the results of the Growth Restriction Intervention Trial (GRIT), please click here