Table 14

Impact of home versus hospital-based bed rest and monitoring in high-risk pregnancy on stillbirth and perinatal mortality

Source

Location and Type of Study

Intervention

Stillbirths/Perinatal Outcomes


Reviews and meta-analyses


Crowther 2001 [127]

Zimbabwe, Finland, Australia.

Meta-analysis (Cochrane). 6 RCTs included (N = 1431 women).

Compared pregnancy outcomes among women with a multiple pregnancy and their babies who were offered bed rest in hospital (intervention) vs. admission to hospital only if complications occurred (controls).

SBR: OR = 0.89 (95% CI: 0.43–1.85) [NS].

[14/698 vs. 16/733 in intervention and control groups, respectively].

PMR: OR = 1.14 (95% CI: 0.65–2.01) [NS].

[26/694 vs. 24/733 in intervention and control groups, respectively].


Meher et al. 2005 [130]

Zimbabwe.

Cochrane review. 1 RCT included (N = 218 women).

To assess the effects on the mother and the baby of some bed rest in hospital (intervention) vs. routine activity at home (controls) for primary treatment of hypertension during pregnancy.

SBR: RR = 4.91 (95% CI: 0.24–101.10) [NS].

[2/110 vs. 0/108 in intervention and control groups, respectively].

PMR: RR = 1.96 (95% CI: 0.18–21.34) [NS].

[2/110 vs. 1/108 in intervention and control groups, respectively].


Intervention studies


Monincx et al. 1997 [131]

The Netherlands (Amsterdam). The Academic Medical Centre.

RCT. N = 150 women recruited between September 1992 and June 1994 (N = 76 intervention group, N = 74 controls).

To compare the outcomes of high-risk pregnancy monitored antenatally at home via domiciliary care (intervention) vs. hospital admission (controls).

SBR: 1/77 (1%) vs. 0/74 in intervention and control groups, respectively.

PMR: 1/77 vs. 1/74 in intervention and control groups, respectively.


[No authors listed] 1990 [132]

China (Shanhai). 6 hospitals.

RCT. Women (N = 13006) of at least 30 wks' gestation (N = 6,506 intervention group, N = 6,500 controls).

Compared the impact on PMR of self-monitoring at home (intervention) vs. controls (without self-monitoring).

PMR: 6.30% vs. 10.92% in intervention and control groups, respectively (statistically significant).

Fetal death (miscarriage + SB): 3.23% vs. 6.34% in intervention and control groups, respectively (statistically significant).


Haws et al. BMC Pregnancy and Childbirth 2009 9(Suppl 1):S5   doi:10.1186/1471-2393-9-S1-S5

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