What do systematic reviews say?

Cervical pessary vs no treatment

Cervical pessary showed no clear difference in neonatal/paediatric care unit admission compared with no treatment (low certainty).

• Cervical pessary for preventing preterm birth in singleton pregnancies 2022 · Cochrane Headline outcomes only
  RR 0.96 [0.58, 1.59]
  3 studies · 1332 participants
  Low

Cervical pessary vs no treatment

Cervical pessary showed no clear difference in fetal/infant mortality compared with no treatment (low certainty).

• Cervical pessary for preventing preterm birth in singleton pregnancies 2022 · Cochrane Headline outcomes only
  RR 0.93 [0.58, 1.48]
  5 studies · 1830 participants
  Low

Cervical pessary vs no treatment

The review found no eligible studies for this question.

• Cervical pessary for preventing preterm birth in singleton pregnancies 2022 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Cervical pessary vs vaginal progesterone

Cervical pessary showed no clear difference in delivery before 34 weeks' gestation compared with vaginal progesterone (moderate certainty).

• Cervical pessary for preventing preterm birth in singleton pregnancies 2022 · Cochrane Headline outcomes only
  RR 0.72 [0.52, 1.02]
  3 studies · 1126 participants
  Moderate

Cervical pessary vs vaginal progesterone

Cervical pessary showed no clear difference in delivery before 37 weeks' gestation compared with vaginal progesterone (moderate certainty).

• Cervical pessary for preventing preterm birth in singleton pregnancies 2022 · Cochrane Headline outcomes only
  RR 0.89 [0.73, 1.09]
  3 studies · 1126 participants
  Moderate

Cervical cerclage in combination with antibiotics and tocolytics vs cervical cerclage

It is very uncertain whether cervical cerclage in combination with antibiotics and tocolytics changes serious neonatal morbidity (Reported in Miller 2014 as 'composite… compared with cervical cerclage alone (very low certainty).

• Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton… 2020 · Cochrane Headline outcomes only
  RR 0.62 [0.31, 1.24]
  1 study · 50 participants
  Very low

Cervical cerclage in combination with antibiotics and tocolytics vs cervical cerclage

The review found no eligible studies for this question.

• Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton… 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Cervical cerclage in combination with antibiotics and tocolytics vs cervical cerclage

The review found no eligible studies for this question.

• Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton… 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intramuscular (IM) progesterone vs no treatment or placebo

Intramuscular (IM) progesterone showed no clear difference in perinatal death compared with no treatment or placebo (low certainty).

• Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy 2019 · Cochrane Headline outcomes only
  RR 1.45 [0.6, 3.51]
  6 studies · 3089 participants
  Low

Intramuscular (IM) progesterone vs no treatment or placebo

• Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy 2019 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Vaginal progesterone vs no treatment or placebo

Vaginal progesterone showed no clear difference in perinatal death compared with no treatment or placebo (low certainty).

• Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy 2019 · Cochrane Headline outcomes only
  RR 1.23 [0.74, 2.06]
  3 studies · 2287 participants
  Low

Vaginal progesterone vs no treatment or placebo

• Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy 2019 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Inhaled steroids vs systemic steroids

Inhaled steroids showed no clear difference in death or BPD at 36 weeks' postmenstrual age compared with systemic steroids (moderate certainty).

• Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth… 2017 · Cochrane Headline outcomes only
  RR 1.04 [0.86, 1.26]
  1 study · 292 participants
  Moderate
• Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth… 2017 · Cochrane Headline outcomes only
  RR 0.94 [0.83, 1.05]
  1 study · 78 participants
  Low

Inhaled steroids vs systemic steroids

Inhaled steroids probably leads to lower diastolic blood pressure > 95th percentile at 7 years compared with systemic steroids (moderate certainty).

• Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth… 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 69 participants
  Moderate

Inhaled steroids vs systemic steroids

Inhaled steroids showed no clear difference in ever diagnosed as asthmatic by 7 years compared with systemic steroids (moderate certainty).

• Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth… 2017 · Cochrane Headline outcomes only
  RR 0.87 [0.55, 1.39]
  1 study · 73 participants
  Moderate

Inhaled steroids vs systemic steroids

Inhaled steroids showed no clear difference in BPD at 36 weeks' postmenstrual age compared with systemic steroids (low certainty).

• Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth… 2017 · Cochrane Headline outcomes only
  RR 1.08 [0.88, 1.32]
  3 studies · 429 participants
  Low

Inhaled steroids vs systemic steroids

Inhaled steroids showed no clear difference in hyperglycaemia compared with systemic steroids (low certainty).

• Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth… 2017 · Cochrane Headline outcomes only
  RR 0.86 [0.61, 1.22]
  3 studies · 429 participants
  Low

Inhaled steroids vs systemic steroids

Inhaled steroids may leads to lower hypertension compared with systemic steroids (low certainty).

• Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth… 2017 · Cochrane Headline outcomes only
  RR 0.86
  3 studies · 429 participants
  Low

Inhaled steroids vs systemic steroids

Inhaled steroids showed no clear difference in general conceptual ability (GCA) score at 7 years The test has a… compared with systemic steroids (moderate certainty).

• Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth… 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 74 participants
  Moderate

Inhaled steroids vs systemic steroids

Inhaled steroids showed no clear difference in moderate/severe disability at 7 years compared with systemic steroids (moderate certainty).

• Inhaled versus systemic corticosteroids for the treatment of bronchopulmonary dysplasia in ventilated very low birth… 2017 · Cochrane Headline outcomes only
  RR 1.4 [0.49, 4.01]
  1 study · 74 participants
  Moderate