What do systematic reviews say?

Simulation‐based obstetric team training vs no training

Simulation‐based obstetric team training showed no clear difference in low Apgar score (Kirkpatrick level 4: patient outcome) compared with no training (low certainty).

• Multi‐professional simulation‐based team training in obstetric emergencies for improving patient outcomes and… 2020 · Cochrane Headline outcomes only
  RR 0.99 [0.85, 1.15]
  2 studies · 115171 participants
  Low

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

Bakri balloon tamponade vs haemostatic square suturing to the lower segment of the uterus (intrauterine tamponade versus another mechanical/surgical method)

• Mechanical and surgical interventions for treating primary postpartum haemorrhage 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 13 participants
  Very low

Bakri balloon tamponade vs haemostatic square suturing to the lower segment of the uterus (intrauterine tamponade versus another mechanical/surgical method)

• Mechanical and surgical interventions for treating primary postpartum haemorrhage 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 13 participants
  Very low

Bakri balloon tamponade vs haemostatic square suturing to the lower segment of the uterus (intrauterine tamponade versus another mechanical/surgical method)

• Mechanical and surgical interventions for treating primary postpartum haemorrhage 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 13 participants
  Very low

Bakri balloon tamponade vs haemostatic square suturing to the lower segment of the uterus (intrauterine tamponade versus another mechanical/surgical method)

The review found no eligible studies for this question.

• Mechanical and surgical interventions for treating primary postpartum haemorrhage 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Bakri balloon tamponade vs haemostatic square suturing to the lower segment of the uterus (intrauterine tamponade versus another mechanical/surgical method)

• Mechanical and surgical interventions for treating primary postpartum haemorrhage 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 13 participants
  Very low

Bakri balloon tamponade vs haemostatic square suturing to the lower segment of the uterus (intrauterine tamponade versus another mechanical/surgical method)

It is very uncertain whether bakri balloon tamponade changes blood transfusion (red cell or whole blood) compared with haemostatic square suturing to the lower segment of the uterus… (very low certainty).

• Mechanical and surgical interventions for treating primary postpartum haemorrhage 2020 · Cochrane Headline outcomes only
  RR 0.57 [0.14, 2.36]
  1 study · 13 participants
  Very low

Bakri balloon tamponade vs haemostatic square suturing to the lower segment of the uterus (intrauterine tamponade versus another mechanical/surgical method)

• Mechanical and surgical interventions for treating primary postpartum haemorrhage 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 13 participants
  Very low

Multiple micronutrients vs control (iron and/or folic acid)

Multiple micronutrients leads to lower low birthweight compared with control (iron with or without folic acid) (high certainty).

• Multiple‐micronutrient supplementation for women during pregnancy 2019 · Cochrane Headline outcomes only
  RR 0.88 [0.85, 0.91]
  18 studies · 68801 participants
  High

Vitamin D plus calcium vs placebo or no intervention

It is very uncertain whether vitamin D + calcium supplementation changes low birthweight (less than 2500 g) compared with placebo or no intervention (very low certainty).

• Vitamin D supplementation for women during pregnancy 2019 · Cochrane Headline outcomes only
  RR 0.68 [0.1, 4.55]
  2 studies · 110 participants
  Very low

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

Vitamin D + calcium + other vitamins and minerals showed no clear difference in low birthweight (less than 2500 g) compared with calcium + other vitamins and minerals (but no vitamin D) (low certainty).

• Vitamin D supplementation for women during pregnancy 2019 · Cochrane Headline outcomes only
  RR 1.12 [0.82, 1.51]
  1 study · 1298 participants
  Low

Vitamin D vs placebo or no intervention

Vitamin D supplementation probably leads to lower low birthweight (less than 2500 g) compared with placebo or no intervention (moderate certainty).

• Vitamin D supplementation for women during pregnancy 2019 · Cochrane Headline outcomes only
  RR 0.55 [0.35, 0.87]
  5 studies · 697 participants
  Moderate

A dose of vitamin D 4000 IU/d or more vs 3999 IU/d or less alone or with any other nutrient

A dose of vitamin D 4000 IU/d or more showed no clear difference in low birthweight compared with 3999 IU/d or less alone or with any other nutrient (low certainty).

• Regimens of vitamin D supplementation for women during pregnancy 2019 · Cochrane Headline outcomes only
  RR 0.92 [0.49, 1.7]
  2 studies · 1099 participants
  Low

Epidural vs opioid

• Epidural versus non‐epidural or no analgesia for pain management in labour 2018 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 1133 participants
  Low

Upright position vs recumbent position

Upright position probably leads to lower low cord pH compared with recumbent position (moderate certainty).

• Maternal position in the second stage of labour for women with epidural anaesthesia 2018 · Cochrane Headline outcomes only
  RR 0.43 [0.2, 0.9]
  2 studies · 3159 participants
  Moderate

Relaxation vs usual care

• Relaxation techniques for pain management in labour 2018 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 271 participants
  Very low

Music vs control

• Relaxation techniques for pain management in labour 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 217 participants
  Very low

Yoga vs control

• Relaxation techniques for pain management in labour 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 66 participants
  Low

Summary of findings for selective ß2‐adrenergic agonist vs no tocolytic agent, whilst awaiting emergency delivery

The review found no eligible studies for this question.

• Acute tocolysis for uterine tachysystole or suspected fetal distress 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found