What do systematic reviews say?

Pre‐prandial vs post‐prandial glucose monitoring

It is very uncertain whether pre‐prandial changes caesarean section compared with post‐prandial glucose monitoring (very low certainty).

• Techniques of monitoring blood glucose during pregnancy for women with pre‐existing diabetes 2019 · Cochrane Headline outcomes only
  RR 1.45 [0.92, 2.28]
  1 study · 61 participants
  Very low

Pre‐mixed insulin (70 NPH/30 REG) vs self‐mixed split dose insulin (Different insulin regimens with similar insulin types used within the regimen)

It is very uncertain whether pre‐mixed insulin (70 NPH/30 REG) changes caesarean section 4 compared with self‐mixed split dose insulin (Different insulin regimens with… (very low certainty).

• Different insulin types and regimens for pregnant women with pre‐existing diabetes 2017 · Cochrane Headline outcomes only
  RR 0.57 [0.25, 1.32]
  1 study · 93 participants
  Very low

Fundal pressure by inflatable belt vs no fundal pressure

It is very uncertain whether fundal pressure by inflatable belt changes operative birth ‐ instrumental or caesarean section compared with no fundal pressure (very low certainty).

• Fundal pressure during the second stage of labour 2017 · Cochrane Headline outcomes only
  RR 0.62 [0.38, 1.01]
  4 studies · 891 participants
  Very low

Acupressure vs sham control

Acupressure probably leads to lower caesarean section compared with sham control (moderate certainty).

• Acupuncture or acupressure for pain management during labour 2020 · Cochrane Headline outcomes only
  RR 0.44 [0.27, 0.71]
  4 studies · 313 participants
  Moderate

Acupressure vs usual care

Acupressure showed no clear difference in caesarean section compared with usual care (low certainty).

• Acupuncture or acupressure for pain management during labour 2020 · Cochrane Headline outcomes only
  RR 0.82 [0.54, 1.23]
  4 studies · 391 participants
  Low

Acupressure vs combined control

It is very uncertain whether acupressure changes caesarean section compared with combined control (very low certainty).

• Acupuncture or acupressure for pain management during labour 2020 · Cochrane Headline outcomes only
  RR 0.48 [0.22, 1.04]
  1 study · 212 participants
  Very low

Acupressure vs sham control

Acupressure showed no clear difference in caesarean section compared with sham control (moderate certainty).

• Acupuncture or acupressure for induction of labour 2017 · Cochrane Headline outcomes only
  RR 0.94 [0.68, 1.3]
  2 studies · 239 participants
  Moderate

Acupressure vs usual care

Acupressure showed no clear difference in caesarean section compared with usual care (moderate certainty).

• Acupuncture or acupressure for induction of labour 2017 · Cochrane Headline outcomes only
  RR 1.02 [0.68, 1.53]
  2 studies · 151 participants
  Moderate

Preconception care vs usual care

• Preconception care for diabetic women for improving maternal and infant health 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Immediate vs deferred delivery of the preterm baby with suspected fetal compromise

Immediate leads to higher caesarean section compared with deferred delivery of the preterm baby with suspected fetal compromise (high certainty).

• Immediate versus deferred delivery of the preterm baby with suspected fetal compromise for improving outcomes 2016 · Cochrane Headline outcomes only
  RR 1.15 [1.07, 1.24]
  1 study · 547 participants
  High

Summary of findings table ‐ Repeat dose(s) of prenatal corticosteroids vs single course

Summary of findings table ‐ Repeat dose(s) of prenatal corticosteroids showed no clear difference in B3: Caesarean section – an all women compared with single course (moderate certainty).

• Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes 2022 · Cochrane Headline outcomes only
  RR 1.03 [0.98, 1.09]
  8 studies · 4266 participants
  Moderate

Summary of findings table ‐ Planned hospital birth vs Planned home birth

• Planned hospital birth compared with planned home birth for pregnant women at low risk of complications 2023 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 11 participants
  Very low

Summary of findings table ‐ Moxibustion plus usual care vs sham moxibustion plus usual care

Summary of findings table ‐ Moxibustion plus usual care showed no clear difference in caesarean section compared with sham moxibustion plus usual care (moderate certainty).

• Cephalic version by moxibustion for breech presentation 2023 · Cochrane Headline outcomes only
  RR 0.84 [0.68, 1.04]
  1 study · 272 participants
  Moderate

Summary of findings table ‐ Moxibustion plus usual care vs usual care

Summary of findings table ‐ Moxibustion plus usual care showed no clear difference in caesarean section compared with usual care (moderate certainty).

• Cephalic version by moxibustion for breech presentation 2023 · Cochrane Headline outcomes only
  RR 0.94 [0.83, 1.05]
  6 studies · 1030 participants
  Moderate

Intervention not reported

The intervention showed no clear difference in caesarean section (low certainty).

• Antenatal dietary supplementation with myo‐inositol for preventing gestational diabetes 2023 · Cochrane Headline outcomes only
  RR 0.91 [0.77, 1.07]
  4 studies · 829 participants
  Low

Probiotics vs placebo

Probiotics showed no clear difference in caesarean section compared with placebo (high certainty).

• Probiotics for preventing gestational diabetes 2021 · Cochrane Headline outcomes only
  RR 1 [0.86, 1.17]
  6 studies · 1520 participants
  High

Additional support vs usual care

Additional support probably leads to lower caesarean section compared with usual care during pregnancy (moderate certainty).

• Support during pregnancy for women at increased risk of low birthweight babies 2019 · Cochrane Headline outcomes only
  RR 0.9 [0.83, 0.97]
  15 studies · 9550 participants
  Moderate

Self‐monitoring at home vs hospitalisation

It is very uncertain whether self‐monitoring at home changes caesarean section compared with hospitalisation (very low certainty).

• Techniques of monitoring blood glucose during pregnancy for women with pre‐existing diabetes 2019 · Cochrane Headline outcomes only
  RR 0.96 [0.65, 1.44]
  1 study · 100 participants
  Very low

Automated telemedicine monitoring vs conventional

It is very uncertain whether automated telemedicine monitoring changes caesarean section compared with conventional (very low certainty).

• Techniques of monitoring blood glucose during pregnancy for women with pre‐existing diabetes 2019 · Cochrane Headline outcomes only
  RR 0.96 [0.62, 1.48]
  1 study · 32 participants
  Very low

Continuous glucose monitoring system vs intermittent glucose monitoring

Continuous glucose monitoring showed no clear difference in caesarean section compared with intermittent glucose monitoring (moderate certainty).

• Techniques of monitoring blood glucose during pregnancy for women with pre‐existing diabetes 2019 · Cochrane Headline outcomes only
  RR 0.94 [0.75, 1.18]
  3 studies · 427 participants
  Moderate