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What do systematic reviews say?

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Evidence found and GRADE certainty

4,410 questions · 8,901 findings · 1,091 reviews

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No studies found 1,687 · 19%GRADE not reported 1,469 · 16.5%Very low 1,969 · 22.1%Low 2,060 · 23.1%Moderate 1,302 · 14.6%High 414 · 4.7%

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Intervention not reported

Cohort studies ‐ autism risk (low), MMR · children 9 months to 15 years old

The intervention showed no clear difference in cohort studies ‐ autism risk (low), MMR (moderate certainty).

1 finding from 1 review

Soft cup vs rigid cup

Low Apgar score · Women in the second stage of labour, requiring an assisted vaginal birth

Soft cup showed no clear difference in low Apgar score at 5 minutes (less than 7 or as defined by trial… compared with rigid cup (low certainty).

1 finding from 1 review

Soft cup vs rigid cup

Low umbilical artery pH (< 7.2 or as defined by trial authors) · Women in the second stage of labour, requiring an assisted vaginal birth

Soft cup showed no clear difference in low umbilical artery pH (< 7.2 or as defined by trial authors) compared with rigid cup (low certainty).

1 finding from 1 review

Handheld vacuum vs any vacuum cup

Low Apgar score · Women in the second stage of labour, requiring an assisted vaginal birth

Handheld vacuum showed no clear difference in low Apgar score at 5 minutes (< 7 or as defined by trial authors) compared with any vacuum cup (low certainty).

1 finding from 1 review

Handheld vacuum vs any vacuum cup

Low umbilical artery pH (< 7.2 or as defined by trial authors) · Women in the second stage of labour, requiring an assisted vaginal birth

Handheld vacuum showed no clear difference in low umbilical artery pH (< 7.2 or as defined by trial authors) compared with any vacuum cup (low certainty).

1 finding from 1 review

Any type of forceps vs any vacuum cup

Low Apgar score · Women in the second stage of labour, requiring an assisted vaginal birth

Any type of forceps showed no clear difference in low Apgar score at 5 minutes (< 7 or as defined by trial authors) compared with any type of vacuum cup (moderate certainty).

1 finding from 1 review

Any type of forceps vs any vacuum cup

Low umbilical artery pH (< 7.2 or as defined by trial authors) · Women in the second stage of labour, requiring an assisted vaginal birth

Any type of forceps showed no clear difference in low umbilical artery pH (< 7.2 or as defined by trial authors) compared with any type of vacuum cup (low certainty).

1 finding from 1 review