{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:59:27Z","timestamp":1783072767880,"version":"3.54.6"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T00:00:00Z","timestamp":1552521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Cure Kids New Zealand"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effect of maternal sildenafil therapy on fetal growth in pregnancies with early\u2010onset fetal growth restriction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A randomised placebo\u2010controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Thirteen maternal\u2013fetal medicine units across New Zealand and Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with singleton pregnancies affected by fetal growth restriction at 22<jats:sup>+0<\/jats:sup> to 29<jats:sup>+6<\/jats:sup> weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women were randomised to oral administration of 25 mg sildenafil citrate or visually matching placebo three times daily until 32<jats:sup>+0<\/jats:sup> weeks, birth or fetal death (whichever occurred first).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>The primary outcome was the proportion of pregnancies with an increase in fetal growth velocity. Secondary outcomes included live birth, survival to hospital discharge free of major neonatal morbidity and pre\u2010eclampsia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sildenafil did not affect the proportion of pregnancies with an increase in fetal growth velocity; 32\/61 (52.5%) sildenafil\u2010treated, 39\/57 (68.4%) placebo\u2010treated [adjusted odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 0.49, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.23\u20131.05] and had no effect on abdominal circumference <jats:italic>Z<\/jats:italic>\u2010scores (<jats:italic>P<\/jats:italic> = 0.61). Sildenafil use was associated with a lower mean uterine artery pulsatility index after 48 hours of treatment (1.56 versus 1.81; <jats:italic>P<\/jats:italic> = 0.02). The live birth rate was 56\/63 (88.9%) for sildenafil\u2010treated and 47\/59 (79.7%) for placebo\u2010treated (adjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.50, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.80\u20137.79); survival to hospital discharge free of major neonatal morbidity was 42\/63 (66.7%) for sildenafil\u2010treated and 33\/59 (55.9%) for placebo\u2010treated (adjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.93, 95% CI 0.84\u20134.45); and new\u2010onset pre\u2010eclampsia was 9\/51 (17.7%) for sildenafil\u2010treated and 14\/55 (25.5%) for placebo\u2010treated (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.67, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.26\u20131.75).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal sildenafil use had no effect on fetal growth velocity. Prospectively planned meta\u2010analyses will determine whether sildenafil exerts other effects on maternal and fetal\/neonatal wellbeing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Maternal sildenafil use has no beneficial effect on growth in early\u2010onset <jats:styled-content style=\"fixed-case\">FGR<\/jats:styled-content>, but also no evidence of harm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15658","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T09:02:14Z","timestamp":1550566934000},"page":"997-1006","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":83,"title":["STRIDER NZAus: a multicentre randomised controlled trial of sildenafil therapy in early\u2010onset fetal growth restriction"],"prefix":"10.1111","volume":"126","author":[{"given":"KM","family":"Groom","sequence":"first","affiliation":[{"name":"Liggins Institute University of Auckland Auckland New Zealand"},{"name":"National Women's Health Auckland City Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LM","family":"McCowan","sequence":"additional","affiliation":[{"name":"National Women's Health Auckland City Hospital Auckland New Zealand"},{"name":"Department of Obstetrics and Gynaecology University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LK","family":"Mackay","sequence":"additional","affiliation":[{"name":"Liggins Institute University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AC","family":"Lee","sequence":"additional","affiliation":[{"name":"Section of Epidemiology and Biostatistics University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Gardener","sequence":"additional","affiliation":[{"name":"Mater Centre for Maternal Fetal Medicine Mater Research Institute Mater Mother's Hospital University of Queensland Brisbane Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Unterscheider","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine Royal Women's Hospital Melbourne Vic Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Vic Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Sekar","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine Royal Brisbane and Women's Hospital Brisbane Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JE","family":"Dickinson","sequence":"additional","affiliation":[{"name":"King Edward Memorial Hospital Perth WA Australia"},{"name":"Division of Obstetrics and Gynaecology University of Western Australia Perth WA 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