Trial reportBMJ (Clinical research ed.)2010
Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT).
Trial report in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 92 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prognostic Value of Diffusion-weighted Cerebral MRI in Prenatal Evaluation of Foetuses With Intra Uterine Growth Restriction.
Mode of Induction in Fetal Growth Restriction and Its Affects on Fetal and Maternal Outcomes
Who cites it
92 citing papers in PubMed, 9 syntheses or guidelines pooled it, 526 citations in OpenAlex.
- Predictive models for adverse pregnancy outcomes in fetal growth restriction: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2026Pooled it
- Universal late pregnancy ultrasound screening to predict adverse outcomes in nulliparous women: a systematic review and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2021Pooled it
- Immediate versus delayed induction of labour in hypertensive disorders of pregnancy: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2020Pooled it
- Neonatal Adverse Outcomes of Induction and Expectant Management in Fetal Growth Restriction: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2020Pooled it
- Early psychosocial development of small for gestational age and intrauterine growth-restricted children: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2019Pooled it
- Delivery or expectant management for prevention of adverse maternal and neonatal outcomes in hypertensive disorders of pregnancy: an individual participant data meta-analysis.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2019Pooled it
- Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta-analysis.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2018Pooled it
- Planned early delivery versus expectant management of the term suspected compromised baby for improving outcomes.The Cochrane database of systematic reviews · 2015Pooled it
- Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014Pooled it
- Computerized CTG self-monitoring versus standard Doppler assessment in late-onset fetal growth restriction (cosmos): a pilot randomized controlled trial.Archives of gynecology and obstetrics · 2026Trial
- The SAVE FGR study: Short term variation Analysis versus Visual Evaluation of cardiotocography in early-onset Fetal Growth Restriction to trigger expedited birth - study protocol for a stepped wedge cluster randomized trial.BMC pregnancy and childbirth · 2026Trial
- Planned delivery or expectant management for late preterm pre-eclampsia in low-income and middle-income countries (CRADLE-4): a multicentre, open-label, randomised controlled trial.Lancet (London, England) · 2023Trial
- Two-year follow-up of infant and maternal outcomes after planned early delivery or expectant management for late preterm pre-eclampsia (PHOENIX): A randomised controlled trial.BJOG : an international journal of obstetrics and gynaecology · 2022Trial
- Associations of severe adverse perinatal outcomes among continuous birth weight percentiles on different birth weight charts: a secondary analysis of a cluster randomized trial.BMC pregnancy and childbirth · 2022Trial
- Customized Probability of Vaginal Delivery With Induction of Labor and Expectant Management in Nulliparous Women at 39 Weeks of Gestation.Obstetrics and gynecology · 2020Trial
- Trial
- Effects of induction of labour versus expectant management in women with impending post-term pregnancies: the 41 week - 42 week dilemma.BMC pregnancy and childbirth · 2014Trial
- A randomised controlled trial comparing standard or intensive management of reduced fetal movements after 36 weeks gestation--a feasibility study.BMC pregnancy and childbirth · 2013Trial
- Induction of labour versus expectant management for nulliparous women over 35 years of age: a multi-centre prospective, randomised controlled trial.BMC pregnancy and childbirth · 2012Trial
- Ursodeoxycholic acid versus placebo, and early term delivery versus expectant management, in women with intrahepatic cholestasis of pregnancy: semifactorial randomised clinical trial.BMJ (Clinical research ed.) · 2012Trial
32 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
26 authors at 16 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the effect of induction of labour with a policy of expectant monitoring for intrauterine growth restriction near term.
designMulticentre randomised equivalence trial (the Disproportionate Intrauterine Growth Intervention Trial At Term (DIGITAT)).
settingEight academic and 44 non-academic hospitals in the Netherlands between November 2004 and November 2008.
participantsPregnant women who had a singleton pregnancy beyond 36+0 weeks' gestation with suspected intrauterine growth restriction.
interventionsInduction of labour or expectant monitoring.
main outcome measuresThe primary outcome was a composite measure of adverse neonatal outcome, defined as death before hospital discharge, five minute Apgar score of less than 7, umbilical artery pH of less than 7.05, or admission to the intensive care unit. Operative delivery (vaginal instrumental delivery or caesarean section) was a secondary outcome. Analysis was by intention to treat, with confidence intervals calculated for the differences in percentages or means.
results321 pregnant women were randomly allocated to induction and 329 to expectant monitoring. Induction group infants were delivered 10 days earlier (mean difference -9.9 days, 95% CI -11.3 to -8.6) and weighed 130 g less (mean difference -130 g, 95% CI -188 g to -71 g) than babies in the expectant monitoring group. A total of 17 (5.3%) infants in the induction group experienced the composite adverse neonatal outcome, compared with 20 (6.1%) in the expectant monitoring group (difference -0.8%, 95% CI -4.3% to 3.2%). Caesarean sections were performed on 45 (14.0%) mothers in the induction group and 45 (13.7%) in the expectant monitoring group (difference 0.3%, 95% CI -5.0% to 5.6%).
conclusionsIn women with suspected intrauterine growth restriction at term, we found no important differences in adverse outcomes between induction of labour and expectant monitoring. Patients who are keen on non-intervention can safely choose expectant management with intensive maternal and fetal monitoring; however, it is rational to choose induction to prevent possible neonatal morbidity and stillbirth.
trial registrationInternational Standard Randomised Controlled Trial number ISRCTN10363217.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.