# DIGITAT trial (induction or monitoring for growth restriction at term) Study · id `maternal:digitat-trial` · Maternal & Newborn Atlas · release `c7fb95f1d15a7d13` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, life stage: Pregnancy; Childbirth Browse, care area: The baby before birth ## In plain language A Dutch trial in women near term whose babies were thought to be growing poorly. Half were offered induction of labour and half were watched closely and left to go into labour on their own. The authors found no important differences in the babies' outcomes between the two approaches. ## Technical summary Multicentre randomised equivalence trial in 8 academic and 44 non-academic hospitals in the Netherlands, November 2004 to November 2008 (BMJ 2010; ISRCTN 10363217). 321 women were allocated to induction and 329 to expectant monitoring. Primary outcome: a composite adverse neonatal outcome (5.3% against 6.1%). The authors found no important differences between induction and expectant monitoring, and say both choices are reasonable. The study is filed under induction of labour as well as fetal growth restriction. The PMC copy is licensed non-commercial, so only the abstract was read. ## Key facts - Design: Multicentre randomised equivalence trial. Pregnant women with a singleton pregnancy beyond 36+0 weeks and suspected intrauterine growth restriction were randomly allocated to induction of labour or expectant monitoring. Analysis was by intention to treat. - Phase: Not reported - Enrolled: 321 women (randomly allocated to induction of labour) (randomized count; Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT), snapshot `maternal:pubmed-21177352-2026-10-14`, retrieved 2026-10-14); 329 women (randomly allocated to expectant monitoring) (randomized count; Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT), snapshot `maternal:pubmed-21177352-2026-10-14`, retrieved 2026-10-14) - Started: Not reported - Primary completion: Not reported - Completion: Not reported - Countries: Netherlands (Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT), snapshot `maternal:pubmed-21177352-2026-10-14`, retrieved 2026-10-14) - Care setting: Not reported - Registry status: Not reported ## Claims, with the population each applies to ## Context: Infants born near term after suspected intrauterine growth restriction, induced or monitored (DIGITAT) Recipient: Newborn; Population: Infants of women with a singleton pregnancy beyond 36+0 weeks and suspected intrauterine growth restriction (321 women allocated to induction and 329 to expectant monitoring). Outcomes in this context are counted in infants.; Care setting: 8 academic and 44 non-academic hospitals; Geography: The Netherlands; Life stage: Birth at or after 36+0 weeks of gestation; outcomes up to hospital discharge; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Death before hospital discharge, five minute Apgar score, umbilical artery pH and intensive care admission ### DIGITAT randomly allocated 321 women with a singleton pregnancy beyond 36+0 weeks and suspected intrauterine growth restriction to induction of labour and 329 to expectant monitoring, in 8 academic and 44 non-academic hospitals in the Netherlands between November 2004 and November 2008. A composite adverse neonatal outcome (death before hospital discharge, five-minute Apgar score below 7, umbilical artery pH below 7.05, or admission to intensive care) occurred in 17 infants (5.3%) after induction and 20 (6.1%) after expectant monitoring (difference -0.8%, 95% CI -4.3% to 3.2%). Induction group infants were born 10 days earlier (mean difference -9.9 days) and weighed 130 g less. The authors found no important differences in adverse outcomes between the two policies. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Newborn; Population: Infants of women with a singleton pregnancy beyond 36+0 weeks and suspected intrauterine growth restriction (321 women allocated to induction and 329 to expectant monitoring). Outcomes in this context are counted in infants.; Care setting: 8 academic and 44 non-academic hospitals; Geography: The Netherlands; Life stage: Birth at or after 36+0 weeks of gestation; outcomes up to hospital discharge; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Death before hospital discharge, five minute Apgar score, umbilical artery pH and intensive care admission - Limitations: The trial tested equivalence, and its confidence interval for the composite (-4.3% to 3.2%) does not rule out differences of a few percentage points either way. It enrolled women in the Netherlands in 2004 to 2008. The authors add that women who prefer no intervention can safely choose expectant management with intensive maternal and fetal monitoring, and that it is rational to choose induction to prevent possible neonatal morbidity and stillbirth. Only the abstract was read; the PMC copy is licensed non-commercial and was not used. - Last checked: 2026-10-14 - Sources: 1. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, DESIGN, sentence 1. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 2. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, SETTING, sentence 1. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 3. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, PARTICIPANTS, sentence 1. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 4. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, INTERVENTIONS, sentence 1. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 5. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN OUTCOME MEASURES, sentence 1, fragment 1 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 6. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN OUTCOME MEASURES, sentence 1, fragment 2 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 7. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, RESULTS, sentence 1. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 8. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, RESULTS, sentence 2, fragment 1 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 9. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, RESULTS, sentence 2, fragment 2 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 10. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, RESULTS, sentence 3, fragment 1 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 11. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, RESULTS, sentence 3, fragment 2 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 12. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, CONCLUSIONS, sentence 1. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 13. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, CONCLUSIONS, sentence 2, fragment 1 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 14. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, CONCLUSIONS, sentence 2, fragment 2 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. ## Context: Women with suspected intrauterine growth restriction near term, induced or monitored (DIGITAT) Recipient: Maternal; Population: Women with a singleton pregnancy beyond 36+0 weeks and suspected intrauterine growth restriction: 321 allocated to induction of labour and 329 to expectant monitoring. Outcomes in this context are counted in mothers.; Care setting: 8 academic and 44 non-academic hospitals; Geography: The Netherlands; Life stage: Pregnancy beyond 36+0 weeks of gestation, labour and birth; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Mode of delivery ### In DIGITAT, caesarean sections were performed on 45 mothers (14.0%) in the induction group and 45 (13.7%) in the expectant monitoring group (difference 0.3%, 95% CI -5.0% to 5.6%). Operative delivery (vaginal instrumental delivery or caesarean section) was a secondary outcome. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Maternal; Population: Women with a singleton pregnancy beyond 36+0 weeks and suspected intrauterine growth restriction: 321 allocated to induction of labour and 329 to expectant monitoring. Outcomes in this context are counted in mothers.; Care setting: 8 academic and 44 non-academic hospitals; Geography: The Netherlands; Life stage: Pregnancy beyond 36+0 weeks of gestation, labour and birth; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Mode of delivery - Limitations: These are secondary outcomes counted in mothers. The confidence interval spans about five percentage points either way. Only the abstract was read. - Last checked: 2026-10-14 - Sources: 1. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, MAIN OUTCOME MEASURES, sentence 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 2. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, RESULTS, sentence 1. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 3. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, RESULTS, sentence 4, fragment 1 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. 4. Supports: Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT) (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, RESULTS, sentence 4, fragment 2 of 2. Retrieved 2026-10-14T18:18:28Z. Source state: Current. Snapshot hash: ae35719dd4adb2c4e098c6a481adf7d72f63e84b56691c1e7daeb13a56c5ec85. How it applies: PubMed abstract. ## Connected pages - Suspected growth restriction near term: Fetal growth restriction (fetus) (`maternal:fetal-growth-restriction`) - Compares induction of labour with expectant monitoring: Induction of labour (`maternal:induction-of-labour`) ## Provenance Content hash: 06ac6ff850d8c1dcbdaf59eac8e1a4010517af79192c40d54be14f23bf2a03f6 Last substantive edit: 2026-10-14 Evidence last checked: 2026-10-14