Findings

What do systematic reviews say?

127 questions · 128 findings · 15 reviews · Pregnancy and Childbirth

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No studies found 19 · 14.8%GRADE not reported 35 · 27.3%Very low 25 · 19.5%Low 29 · 22.7%Moderate 12 · 9.4%High 8 · 6.3%

Antibiotics vs placebo or no treatment

Endometritis · Women undergoing operative vaginal delivery

Any antibiotics showed no clear difference in endometritis № of participants: 3813 (2 RCTs) compared with placebo or no treatment (low certainty).

1 finding from 1 review

Antibiotic prophylaxis for operative vaginal delivery 2020 · Cochrane Headline outcomes only
RR 0.32 [0.04, 2.64]
Studies not reported
Low

Antibiotics vs placebo or no treatment

Urinary tract infection ‐ not measured · Women undergoing operative vaginal delivery

The review found no eligible studies for this question.

1 finding from 1 review

Antibiotic prophylaxis for operative vaginal delivery 2020 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Antibiotics vs placebo or no treatment

Serious infectious complications · Women undergoing operative vaginal delivery

Any antibiotics leads to lower serious infectious complications № of participants: 3420 (1 RCT) compared with placebo or no treatment (high certainty).

1 finding from 1 review

Antibiotic prophylaxis for operative vaginal delivery 2020 · Cochrane Headline outcomes only
RR 0.44 [0.22, 0.89]
Studies not reported
High

Antibiotics vs placebo or no treatment

Maternal adverse reactions · Women undergoing operative vaginal delivery

Any antibiotics showed no clear difference in maternal adverse reactions № of participants: 2593 (1 RCT) compared with placebo or no treatment (low certainty).

1 finding from 1 review

Antibiotic prophylaxis for operative vaginal delivery 2020 · Cochrane Headline outcomes only
RR 2 [0.18, 22.05]
Studies not reported
Low

Prophylactic antibiotics vs placebo

Preterm prelabour rupture of membranes · women in the second or third trimester of pregnancy before labour and delivery

Prophylactic antibiotics showed no clear difference in preterm prelabour rupture of membranes compared with placebo (low certainty).

1 finding from 1 review

Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity 2015 · Cochrane Headline outcomes only
RR 0.31 [0.06, 1.49]
1 study · 229 participants
Low

Prophylactic antibiotics vs placebo

Prelabour rupture of membranes · women in the second or third trimester of pregnancy before labour and delivery

Prophylactic antibiotics may leads to lower prelabour rupture of membranes compared with placebo (low certainty).

1 finding from 1 review

Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity 2015 · Cochrane Headline outcomes only
RR 0.34 [0.15, 0.78]
1 study · 229 participants
Low

Prophylactic antibiotics vs placebo

Preterm birth · women in the second or third trimester of pregnancy before labour and delivery

Prophylactic antibiotics showed no clear difference in preterm delivery compared with placebo (high certainty).

1 finding from 1 review

Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity 2015 · Cochrane Headline outcomes only
RR 0.88 [0.72, 1.09]
6 studies · 3663 participants
High

Prophylactic antibiotics vs placebo

Chorioamnionitis · women in the second or third trimester of pregnancy before labour and delivery

It is very uncertain whether prophylactic antibiotics changes chorioamnionitis compared with placebo (very low certainty).

1 finding from 1 review

Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity 2015 · Cochrane Headline outcomes only
RR 0.62 [0.1, 3.62]
1 study · 229 participants
Very low

Prophylactic antibiotics vs placebo

Puerperal sepsis/postpartum endometritis · women in the second or third trimester of pregnancy before labour and delivery

Prophylactic antibiotics probably leads to lower puerperal sepsis/postpartum endometritis compared with placebo (moderate certainty).

1 finding from 1 review

Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity 2015 · Cochrane Headline outcomes only
RR 0.53 [0.35, 0.82]
3 studies · 627 participants
Moderate

Prophylactic intravenous antibiotics administered before cesarean incision vs after neonatal umbilical cord clamping

Maternal composite morbidity · women undergoing caesarean section

Prophylactic intravenous antibiotics administered before cesarean… leads to lower maternal composite morbidity compared with after neonatal umbilical cord clamping (high certainty).

1 finding from 1 review

Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing… 2014 · Cochrane Headline outcomes only
RR 0.67 [0.54, 0.82]
10 studies · 5041 participants
High

Prophylactic intravenous antibiotics administered before cesarean incision vs after neonatal umbilical cord clamping

Endomyometritis · women undergoing caesarean section

Prophylactic intravenous antibiotics administered before cesarean… leads to lower maternal endomyometritis compared with after neonatal umbilical cord clamping (high certainty).

1 finding from 1 review

Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing… 2014 · Cochrane Headline outcomes only
RR 0.54 [0.36, 0.79]
10 studies · 5041 participants
High

Prophylactic intravenous antibiotics administered before cesarean incision vs after neonatal umbilical cord clamping

Wound infection · women undergoing caesarean section

Prophylactic intravenous antibiotics administered before cesarean… leads to lower maternal wound Infection compared with after neonatal umbilical cord clamping (high certainty).

1 finding from 1 review

Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing… 2014 · Cochrane Headline outcomes only
RR 0.59 [0.44, 0.81]
10 studies · 5041 participants
High

Prophylactic intravenous antibiotics administered before cesarean incision vs after neonatal umbilical cord clamping

Maternal UTI/cystitis/pyelonephritis · women undergoing caesarean section

Prophylactic intravenous antibiotics administered before cesarean… showed no clear difference in maternal UTI/cystitis/pyelonephritis compared with after neonatal umbilical cord clamping (moderate certainty).

1 finding from 1 review

Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing… 2014 · Cochrane Headline outcomes only
RR 1.02 [0.65, 1.59]
8 studies · 4001 participants
Moderate

Prophylactic intravenous antibiotics administered before cesarean incision vs after neonatal umbilical cord clamping

Maternal respiratory infection (pneumonia) · women undergoing caesarean section

Prophylactic intravenous antibiotics administered before cesarean… showed no clear difference in maternal respiratory infection (pneumonia) compared with after neonatal umbilical cord clamping (low certainty).

1 finding from 1 review

Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing… 2014 · Cochrane Headline outcomes only
RR 2.3 [0.34, 15.45]
2 studies · 1158 participants
Low

Prophylactic intravenous antibiotics administered before cesarean incision vs after neonatal umbilical cord clamping

Neonatal sepsis · women undergoing caesarean section

Prophylactic intravenous antibiotics administered before cesarean… showed no clear difference in neonatal sepsis compared with after neonatal umbilical cord clamping (moderate certainty).

1 finding from 1 review

Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing… 2014 · Cochrane Headline outcomes only
RR 0.76 [0.51, 1.13]
5 studies · 2907 participants
Moderate

Prophylactic intravenous antibiotics administered before cesarean incision vs after neonatal umbilical cord clamping

Admission to neonatal intensive care unit · women undergoing caesarean section

Prophylactic intravenous antibiotics administered before cesarean… showed no clear difference in neonatal ICU admission compared with after neonatal umbilical cord clamping (high certainty).

1 finding from 1 review

Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing… 2014 · Cochrane Headline outcomes only
RR 0.91 [0.74, 1.13]
6 studies · 3708 participants
High

Cervical cerclage in combination with antibiotics and tocolytics vs cervical cerclage

Serious neonatal morbidity

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).

1 finding from 1 review

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

Perinatal loss: all ‐ including miscarriages and stillbirth (Note: data not available for neonatal death)

It is very uncertain whether cervical cerclage in combination with antibiotics and tocolytics changes perinatal loss: all ‐ including miscarriages and stillbirth (Note:… compared with cervical cerclage alone (very low certainty).

1 finding from 1 review

Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton… 2020 · Cochrane Headline outcomes only
RR 0.46 [0.13, 1.64]
1 study · 50 participants
Very low

Cervical cerclage in combination with antibiotics and tocolytics vs cervical cerclage

Baby discharged home healthy

The review found no eligible studies for this question.

1 finding from 1 review

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

Death of the baby before discharge: neonatal death

The review found no eligible studies for this question.

1 finding from 1 review

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