Antenatal interventions to reduce preterm birth: an overview of Cochrane systematic reviews

BMC Research Notes

Roman Winkler¹  Ingrid Zechmeister-Koss¹  Brigitte Piso¹ 

[1] Ludwig Boltzmann Institute for Health Technology Assessment, Garnisongasse 7/20, 1090 Wien, Austria

关键词: Pregnancy;    Maternity and child health;    Premature birth;   

Others  :  1133239
DOI  :  10.1186/1756-0500-7-265

 received in 2013-05-27, accepted in 2014-04-04,  发布年份 2014

【 摘 要 】

Background

Several factors are associated with an increased risk of preterm birth (PTB); therefore, various interventions might have the potential to influence it. Due to the large number of interventions that address PTB, the objective of this overview is to summarise evidence from Cochrane reviews regarding the effects and safety of these different interventions.

Methods

We conducted a systematic literature search in the Cochrane Database of Systematic Reviews. Included reviews should be based on randomised controlled trials comparing antenatal non-pharmacological and pharmacological interventions that directly or indirectly address PTB with placebo/no treatment or routine care in pregnant women at less than 37 completed weeks of gestation without signs of threatened preterm labour. We considered PTB at less than 37 completed weeks of gestation as the primary outcome.

Results

We included 56 Cochrane systematic reviews. Three interventions increased PTB risk significantly. Twelve interventions led to a statistically significant lower incidence of PTBs. However, this reduction was mostly observed in defined at-risk subgroups of pregnant women. The remaining antenatal interventions failed to prove a significant effect on PTB < 37 weeks, but some of them at least showed a positive effect in secondary outcomes (e.g., reduction in early PTBs). As an unintended result of this review, we identified 28 additional Cochrane reviews which intended to report on PTB < 37 weeks, but were not able to find any RCTs reporting appropriate data.

Conclusions

The possible effects of a diverse range of interventions on PTB have been evaluated in Cochrane systematic reviews. Few interventions have been demonstrated to be effective and a small number have been found to be harmful. For around half of the interventions evaluated, the Cochrane review concluded that there was insufficient evidence to provide sound recommendations for clinical practice. No RCT evidence is available for a number of potentially relevant interventions.

【 授权许可】

   
2014 Piso et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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