What do systematic reviews say?

54 questions · 54 findings · 35 reviews · Pregnancy and Childbirth

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No studies found 1 · 1.9%GRADE not reported 4 · 7.4%Very low 8 · 14.8%Low 22 · 40.7%Moderate 8 · 14.8%High 11 · 20.4%

Intramuscular (IM) progesterone vs no treatment or placebo

Preterm birth · Women with a multiple pregnancy

Intramuscular (IM) progesterone showed no clear difference in preterm birth less than 37 weeks compared with no treatment or placebo (high certainty).

1 finding from 1 review

Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy 2019 · Cochrane Headline outcomes only
RR 1.05 [0.98, 1.13]
5 studies · 2010 participants
High

Vaginal progesterone vs no treatment or placebo

Preterm birth less than 34 weeks' gestation · Women with a multiple pregnancy

Vaginal progesterone showed no clear difference in preterm birth less than 34 weeks compared with no treatment or placebo (low certainty).

1 finding from 1 review

Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy 2019 · Cochrane Headline outcomes only
RR 0.9 [0.66, 1.23]
5 studies · 1503 participants
Low

Acupuncture vs placebo

Preterm birth · Pregnant women with hyperemesis gravidarum

Acupuncture showed no clear difference in preterm birth less than 37 weeks compared with placebo (low certainty).

1 finding from 1 review

Interventions for treating hyperemesis gravidarum 2016 · Cochrane Headline outcomes only
RR 0.12 [0.01, 2.26]
1 study · 36 participants
Low

Lower genital tract infection screening vs No screening

Preterm birth · pregnant women presenting for routine prenatal care

Lower genital tract infection screening probably leads to lower preterm birth less than 37 weeks compared with no screening (moderate certainty).

1 finding from 1 review

Antenatal lower genital tract infection screening and treatment programs for preventing preterm delivery 2015 · Cochrane Headline outcomes only
RR 0.55 [0.41, 0.75]
1 study · 4155 participants
Moderate

Intervention not reported

Any preterm birth (birth < 37 weeks) · women with a previous stillbirth of > 20 weeks' gestation who are pregnant or considering a subsequent pregnancy

It is very uncertain whether the intervention changes any preterm birth (birth < 37 weeks) (very low certainty).

1 finding from 1 review

Care prior to and during subsequent pregnancies following stillbirth for improving outcomes 2018 · Cochrane Headline outcomes only
RR 0.42 [0.04, 4.06]
1 study · 24 participants
Very low

Intervention not reported

Any preterm birth (birth < 37 weeks) · women with a previous stillbirth of ≥ 20 weeks' gestation who are pregnant or considering a subsequent pregnancy

The intervention showed no clear difference in any preterm birth (birth < 37 weeks) (low certainty).

1 finding from 1 review

Care prior to and during subsequent pregnancies following stillbirth for improving outcomes 2018 · Cochrane Headline outcomes only
RR 1.01 [0.58, 1.74]
3 studies · 114 participants
Low

Intervention not reported

Preterm birth (< 37 weeks' gestation) · All pregnant women receiving either vitamin C supplementation or control either in areas where there is inadequate dietary intake or where…

The intervention showed no clear difference in preterm birth (< 37 weeks' gestation) (high certainty).

1 finding from 1 review

Vitamin C supplementation in pregnancy 2015 · Cochrane Headline outcomes only
RR 0.99 [0.9, 1.1]
16 studies · 22250 participants
High

Cerclage vs no cerclage

Preterm birth less than 34 weeks' gestation · preventing preterm birth in women with singleton pregnancy

Cerclage leads to lower preterm birth before 34 completed weeks compared with no cerclage (high certainty).

1 finding from 1 review

Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy 2017 · Cochrane Headline outcomes only
RR 0.77 [0.66, 0.89]
9 studies · 2415 participants
High

Calcium supplementation/fortification vs placebo or no intervention

Gestational age (preterm birth < 37 weeks) · healthy pregnant women receiving calcium supplementation vs placebo or no treatment

Calcium supplementation showed no clear difference in preterm birth (a) Birth prior to 37 weeks compared with placebo or no treatment (maternal outcomes) (moderate certainty).

1 finding from 1 review

Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes 2015 · Cochrane Headline outcomes only
RR 0.86 [0.7, 1.05]
13 studies · 16139 participants
Moderate

Calcium supplementation/fortification vs placebo or no intervention

Preterm birth less than 34 weeks' gestation · healthy pregnant women receiving calcium supplementation vs placebo or no treatment

Calcium supplementation showed no clear difference in preterm birth (b) Birth prior to 34 weeks compared with placebo or no treatment (maternal outcomes) (moderate certainty).

1 finding from 1 review

Calcium supplementation (other than for preventing or treating hypertension) for improving pregnancy and infant outcomes 2015 · Cochrane Headline outcomes only
RR 1.04 [0.8, 1.36]
4 studies · 5669 participants
Moderate

Intervention not reported

Preterm birth (before 37 weeks' gestation) · pregnant women considered to be at risk of developing pre‐eclampsia

The intervention leads to lower preterm birth (before 37 weeks' gestation) (high certainty).

1 finding from 1 review

Antiplatelet agents for preventing pre‐eclampsia and its complications 2019 · Cochrane Headline outcomes only
RR 0.91 [0.87, 0.95]
47 studies · 35212 participants
High

Intervention not reported

Preterm birth less than 34 weeks' gestation · women undergoing home monitoring for preventing preterm birth versus women receiving standard care

The intervention leads to lower preterm birth less than 34 weeks' gestation (high certainty).

1 finding from 1 review

Home uterine monitoring for detecting preterm labour 2017 · Cochrane Headline outcomes only
RR 0.78 [0.62, 0.99]
3 studies · 1596 participants
High

Intervention not reported

Preterm birth less than 37 weeks' gestation · women undergoing home monitoring for preventing preterm birth versus women receiving standard care

It is very uncertain whether the intervention changes preterm birth less than 37 weeks' gestation (very low certainty).

1 finding from 1 review

Home uterine monitoring for detecting preterm labour 2017 · Cochrane Headline outcomes only
RR 0.85 [0.72, 1.01]
8 studies · 4834 participants
Very low

SOF Immunological sealant vs usual care

Preterm birth · preterm prelabour rupture of membranes (PPROM)

It is very uncertain whether SOF Immunological sealant changes preterm birth less than 37 weeks' gestation compared with standard care (very low certainty).

1 finding from 1 review

Sealing procedures for preterm prelabour rupture of membranes 2016 · Cochrane Headline outcomes only
RR 0.48 [0.34, 0.68]
1 study · 94 participants
Very low

SOF Cervical adapter vs usual care

Preterm birth · preterm prelabour rupture of membranes (PPROM)

1 finding from 1 review

Sealing procedures for preterm prelabour rupture of membranes 2016 · Cochrane Headline outcomes only
no estimate extracted
0 studies · 0 participants
GRADE not reported

Vitamin D plus calcium vs placebo or no intervention

Preterm birth · pregnant women and their infants..

Vitamin D + calcium supplementation may leads to higher preterm birth (less than 37 weeks' gestation) compared with placebo or no intervention (low certainty).

1 finding from 1 review

Vitamin D supplementation for women during pregnancy 2019 · Cochrane Headline outcomes only
RR 1.52 [1.01, 2.28]
5 studies · 942 participants
Low

Vitamin D + calcium + other vitamins and minerals vs calcium + other vitamins and minerals (but no vitamin D)

Preterm birth · pregnant women and their infants..

Vitamin D + calcium + other vitamins and minerals showed no clear difference in preterm birth (less than 37 weeks' gestation) compared with calcium + other vitamins and minerals (but no vitamin D) (low certainty).

1 finding from 1 review

Vitamin D supplementation for women during pregnancy 2019 · Cochrane Headline outcomes only
RR 1.04 [0.68, 1.59]
1 study · 1298 participants
Low

Vitamin D vs placebo or no intervention

Preterm birth · pregnant women and their infants..

Vitamin D supplementation showed no clear difference in preterm birth (less than 37 weeks' gestation) compared with placebo or no intervention (low certainty).

1 finding from 1 review

Vitamin D supplementation for women during pregnancy 2019 · Cochrane Headline outcomes only
RR 0.66 [0.34, 1.3]
7 studies · 1640 participants
Low

Vitamin E vs placebo, no placebo or other supplements

Preterm birth · pregnant women receiving vitamin E supplementation or control, living in areas where there is either inadequate dietary intake of vitamin…

Any vitamin E supplementation showed no clear difference in preterm birth (less than 37 weeks' gestation) compared with placebo, no placebo or other supplements (high certainty).

1 finding from 1 review

Vitamin E supplementation in pregnancy 2015 · Cochrane Headline outcomes only
RR 0.98 [0.88, 1.09]
11 studies · 20565 participants
High

Oral betamimetic vs placebo

Preterm birth · women with a twin pregnancy

Oral betamimetic showed no clear difference in preterm birth (less than 37 weeks' gestation) compared with placebo (low certainty).

1 finding from 1 review

Prophylactic oral betamimetics for reducing preterm birth in women with a twin pregnancy 2015 · Cochrane Headline outcomes only
RR 0.85 [0.65, 1.1]
4 studies · 276 participants
Low