Table 2

Excluded High Quality Reviews Reporting Interventions with no effect
Author & Year Number of papers included (date range) Intervention Key outcomes of Interest Key Findings
Bricker et al. [18] 8 (1984-2003) Routine USS in pregnancy after 24weeks Primary: induction of labour, caesarean section, all deaths, preterm delivery <34weeks, neurodevelopment at age 2yrs & maternal psychological effects No difference in antenatal, obstetric and neonatal intervention or morbidity in groups
Secondary: interventions, additional maternal, perinatal and neonatal outcomes) Routine USS not associated with improved perinatal mortality Increased Caesarean rate in screened group-non significant (RR 1.06 95% CI 1.00 -1.13, p = 0.07)
Carrolli et al. [19] 7 (1995-2001) Routine antenatal care patterns Effect of reduced number of visits v standard number of visits on: Pre-eclampsia, UTI, postpartum anaemia, maternal mortality, LBW and perinatal mortality Pre-eclampsia: no difference (OR 0.91 95% CI 0.66-1.26)
UTI: no difference (OR 0.93 95% CI 0.79-1.10)
Postpartum anaemia: no difference (OR 1.01)
Maternal mortality :no difference (OR 0.91 95% CI 0.55-1.51)
LBW: no difference (OR 1.04 95% CI 0.93-1.17)
Perinatal mortality: rates similar although rare outcome so no statistical equivalence
Some dissatisfaction of women with care and fewer visits
Grivell et al. [20] 6 (1982-1999) Cochrane: Antenatal CTG for fetal assessment Primary: perinatal mortality and CS Comparison of traditional CTG versus no CTG showed no significant difference identified in perinatal mortality (RR 2.05, 95% CI 0.95 to 4.42, 2.3% versus 1.1%, four studies, N = 1627)
Secondary: potentially preventable perinatal mortality (exc lethal congenital anomalies), Apgar < 7 @ 5mins, Apgar < 4@ 5mins, Cord pH < 7.10 or low pH/low base excess, Admission to NICU/ICU, Length of stay in neonatal SCU or ICU, Preterm birth (< 37 completed weeks, <34 completed weeks, <28 completed weeks), Gestational age at birth No significant difference identified in caesarean sections (RR 1.06, 95% CI 0.88 to 1.28, 19.7% versus 18.5%, three trials, N = 1279) nor in the secondary outcomes that were assessed.
Neonatal seizures, Hypoxic ischaemic encephalopathy, Cerebral palsy at 12 months, neurodevelopmental disability at more than 12 months, CS non-reassuring or abnormal FHR, IOL , antenatal hospital admission, length of antenatal hospital stay, emotional distress, depression, anxiety and satisfaction with care
Kongnyuy et al. [21] 5 (1999-2006) Provision of advice regarding vitamin A supplementation in HIV infected women Risk of Mother-to-Child Transmission (MTCT) of HIV,birth weight, stillbirth rate and PTD No evidence of an effect on the risk of prenatal or postnatal MTCT of HIV (RR 1.06, 95% CI 0.89-1.26). Prenatal vitamin A improved infant birth weight (WMD 89.78, 95% CI 84.73-94.83), but had no effect on stillbirth rate (RR 0.99, 95% CI 0.68-1.43) or PTD (RR 0.88, 95% CI 0.65-1.19).
Rumbold et al. [22] 10 (1994-2006) Antioxidant supplementation for preventing pre-eclampsia Pre-eclampsia, severe pre-eclampsia, preterm birth, SGA infants, infant death No significant difference for pre-eclampsia or any other primary outcome-does not support routine antioxidant supplementation to reduce risk of pre-eclampsia
Villar et al. [23] 10 (1992-2001) Provision of antenatal care for low risk pregnancy-reduced number of visits Preterm delivery, pre-eclampsia, anaemia, urinary tract infection, CS, IOL, APH, PPH, LBW, SGA, perinatal mortality, maternal mortality, cost effectiveness and perception of care No difference in any outcomes
Women in developed countries are more likely to be less satisfied with with fewer visits
Antenatal care provided by a midwife/general practitioner was associated with improved perception of care by women

Acronyms used: USS=Ultrasound Scan; CI=confidence interval; RR=relative risk; UTI=urinary tract infection; OR=odds ratio; LBW=low birth weight; CS=caesarean section; NICU=neonatal intensive care unit; ICU=intensive care unit; SCU=special care unit; FHR=fetal heart rate; IOL=induction of labour; CTG=cardiotocography; PTD=preterm delivery; WMD=weighted mean difference; APH=antepartum haemorrhage; PPH=postpartum haemorrhage; SGA=small for gestational age.

McNeill et al.

McNeill et al. BMC Public Health 2012 12:955   doi:10.1186/1471-2458-12-955

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