What do systematic reviews say?

Multivitamin vs no multivitamins

Multivitamins showed no clear difference in preterm birth < 37 weeks Gestational age was determined using date… compared with no multivitamins (moderate certainty).

• Micronutrient supplementation in pregnant women with HIV infection 2012 · Cochrane Headline outcomes only
  RR 0.86 [0.68, 1.1]
  1 study · 888 participants
  Moderate

Probiotics administered exclusively after birth in mothers of preterm infants vs placebo or no intervention

Probiotics administered exclusively after birth in mothers of… showed no clear difference in any necrotizing Enterocolitis (NEC) compared with maternal placebo or no intervention (low certainty).

• Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants 2018 · Cochrane Headline outcomes only
  RR 0.44 [0.13, 1.46]
  1 study · 58 participants
  Low

Probiotics administered exclusively after birth in mothers of preterm infants vs placebo or no intervention

Probiotics administered exclusively after birth in mothers of… showed no clear difference in death prior to hospital discharge compared with maternal placebo or no intervention (low certainty).

• Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants 2018 · Cochrane Headline outcomes only
  RR 0.66 [0.06, 6.88]
  1 study · 58 participants
  Low

Probiotics administered exclusively after birth in mothers of preterm infants vs placebo or no intervention

Probiotics administered exclusively after birth in mothers of… showed no clear difference in death or NEC compared with maternal placebo or no intervention (low certainty).

• Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants 2018 · Cochrane Headline outcomes only
  RR 0.53 [0.19, 1.49]
  1 study · 58 participants
  Low

Probiotics administered exclusively after birth in mothers of preterm infants vs placebo or no intervention

Probiotics administered exclusively after birth in mothers of… showed no clear difference in surgery for NEC compared with maternal placebo or no intervention (low certainty).

• Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants 2018 · Cochrane Headline outcomes only
  RR 0.15 [0.01, 2.58]
  1 study · 58 participants
  Low

Probiotics administered exclusively after birth in mothers of preterm infants vs placebo or no intervention

Probiotics administered exclusively after birth in mothers of… showed no clear difference in neonatal sepsis compared with maternal placebo or no intervention (low certainty).

• Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants 2018 · Cochrane Headline outcomes only
  RR 1.32 [0.48, 3.61]
  1 study · 58 participants
  Low

Probiotics administered exclusively after birth in mothers of preterm infants vs placebo or no intervention

• Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 58 participants
  Low

Probiotics administered exclusively after birth in mothers of preterm infants vs placebo or no intervention

• Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 58 participants
  Low

Inositol supplementation IV initially followed by enteral administration (repeat doses of 80 mg/kg/day) in preterm infants born at less than 30 weeks' PMA vs placebo

Inositol supplementation IV initially followed by enteral… showed no clear difference in BPD or death by it prior to 37 weeks' PMA (outcomes collected… compared with placebo (high certainty).

• Inositol in preterm infants at risk for or having respiratory distress syndrome 2019 · Cochrane Headline outcomes only
  RR 1.01 [0.87, 1.16]
  2 studies · 616 participants
  High

Inositol supplementation IV initially followed by enteral administration (repeat doses of 80 mg/kg/day) in preterm infants born at less than 30 weeks' PMA vs placebo

Inositol supplementation IV initially followed by enteral… showed no clear difference in all‐cause mortality (outcome collected through first event: death,… compared with placebo (moderate certainty).

• Inositol in preterm infants at risk for or having respiratory distress syndrome 2019 · Cochrane Headline outcomes only
  RR 1.35 [0.91, 2]
  2 studies · 701 participants
  Moderate

Magnesium sulphate vs placebo (outcomes

Magnesium sulphate showed no clear difference in mode of birth (caesarean section)** compared with placebo (outcomes (moderate certainty).

• Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus 2024 · Cochrane Headline outcomes only
  RR 0.96 [0.91, 1.02]
  5 studies · 5861 participants
  Moderate

Corticosteroids vs placebo or no treatment

• Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  High

Strategies to increase use of antenatal corticosteroids vs usual care

Strategies to increase use of antenatal corticosteroids probably leads to higher stillbirth (at population level) compared with routine (usual) care (moderate certainty).

• Strategies for optimising antenatal corticosteroid administration for women with anticipated preterm birth 2020 · Cochrane Headline outcomes only
  RR 1.11 [1.02, 1.21]
  1 study · 100705 participants
  Moderate

Plastic wrap or bag vs usual care

• Interventions to prevent hypothermia at birth in preterm and/or low birth weight infants 2018 · Cochrane Headline outcomes only
  no estimate extracted
  13 studies · 1633 participants
  Moderate
• Interventions to prevent hypothermia at birth in preterm and/or low birth weight infants 2018 · Cochrane Headline outcomes only
  no estimate extracted
  6 studies · 373 participants
  Moderate

Cerclage vs no cerclage

Cerclage showed no clear difference in stillbirths compared with no cerclage (low certainty).

• Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy 2017 · Cochrane Headline outcomes only
  RR 0.89 [0.45, 1.75]
  5 studies · 1803 participants
  Low

Cycled light (CL) vs continuous bright light (CBL)

• Cycled light in the intensive care unit for preterm and low birth weight infants 2016 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 79 participants
  Low

Cycled light (CL) vs continuous bright light (CBL)

• Cycled light in the intensive care unit for preterm and low birth weight infants 2016 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 41 participants
  Low

Planned early birth vs expectant management

Planned early birth showed no clear difference in neonatal infection/sepsis compared with expectant management (moderate certainty).

• Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37… 2017 · Cochrane Headline outcomes only
  RR 0.93 [0.66, 1.3]
  12 studies · 3628 participants
  Moderate

Planned early birth vs expectant management

Planned early birth leads to higher neonatal respiratory distress syndrome compared with expectant management (high certainty).

• Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37… 2017 · Cochrane Headline outcomes only
  RR 1.26 [1.05, 1.53]
  12 studies · 3622 participants
  High

Planned early birth vs expectant management

Planned early birth leads to higher need for ventilation compared with expectant management (high certainty).

• Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37… 2017 · Cochrane Headline outcomes only
  RR 1.27 [1.02, 1.58]
  7 studies · 2895 participants
  High