Cochrane · systematic review · CD011516
Assessment and support during early labour for improving birth outcomes
Kobayashi, S, Hanada, N, Matsuzaki, M, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
18
No studies
1
Included studies
NR
No studies 1 · 4.8%Ungraded 2 · 9.5%Very low 4 · 19%Low 7 · 33.3%Moderate 3 · 14.3%High 4 · 19%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Assessment compared to direct admission in early labour for improving birth outcomes
Population: healthy pregnant women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Length of labour (hours) Assessment vs direct admission | no estimate extracted | 1 study · 209 participants | Low Downgraded: risk of bias |
Rate of caesarean section Assessment vs direct admission | RR 0.72 [0.3, 1.72] | 1 study · 209 participants | Very low Downgraded: risk of bias |
Rate of instrumental vaginal birth Assessment vs direct admission | RR 0.86 [0.58, 1.26] | 1 study · 209 participants | Very low Downgraded: risk of bias |
Serious maternal morbidity Assessment vs direct admission | no estimate extracted | 0 studies · 0 participants | Ungraded |
Use of epidural or any regional anaesthesia Assessment vs direct admission | RR 0.87 [0.78, 0.98] | 1 study · 209 participants | Low Downgraded: risk of bias |
Neonatal admission to special care Assessment vs direct admission | no estimate extracted | NR | No studies |
Apgar score < 7 at 5 minutes Assessment vs direct admission | RR 2.97 [0.12, 72.12] | 1 study · 209 participants | Very low Downgraded: risk of bias |
Home support compared to telephone triage for improving birth outcomes
Population: healthy pregnant women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Length of labour (hours) Home support vs telephone triage | no estimate extracted | 1 study · 3474 participants | Low Downgraded: risk of bias |
Rate of caesarean section Home support vs telephone triage | RR 1.05 [0.95, 1.17] | 3 studies · 5170 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Rate of instrumental vaginal birth Home support vs telephone triage | RR 0.95 [0.79, 1.15] | 2 studies · 4933 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Serious maternal morbidity Home support vs telephone triage | RR 0.93 [0.61, 1.42] | 1 study · 3474 participants | Low Downgraded: risk of bias |
Use of epidural or any regional anaesthesia Home support vs telephone triage | RR 0.95 [0.87, 1.05] | 3 studies · 5168 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Neonatal admission to special care Home support vs telephone triage | RR 0.84 [0.5, 1.42] | 3 studies · 5170 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Apgar score < 7 at 5 minutes Home support vs telephone triage | RR 1.19 [0.71, 1.99] | 3 studies · 5170 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
One‐to‐one structured care compared to usual care for improving birth outcomes
Population: healthy pregnant women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Length of labour (hours) One‐to‐one structured care vs usual care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rate of caesarean section One‐to‐one structured care vs usual care | RR 0.93 [0.84, 1.02] | 1 study · 4996 participants | High |
Rate of instrumental vaginal birth One‐to‐one structured care vs usual care | RR 0.94 [0.82, 1.08] | 1 study · 4996 participants | High |
Serious maternal morbidity One‐to‐one structured care vs usual care | RR 1.13 [0.84, 1.52] | 1 study · 4996 participants | Moderate |
Use of epidural or any regional anaesthesia One‐to‐one structured care vs usual care | RR 1 [0.99, 1.01] | 1 study · 4996 participants | High |
Neonatal admission to special care One‐to‐one structured care vs usual care | RR 0.98 [0.8, 1.21] | 1 study · 4989 participants | High |
Apgar score < 7 at 5 minutes One‐to‐one structured care vs usual care | RR 1.07 [0.64, 1.79] | 1 study · 4989 participants | Moderate |