Table 5.
Certainty of the evidence using the GRADE approach by outcomes
| No of studies | Design | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Antenatal education | Routine prenatal care | Pooled effect Relative (95% CI) |
Final judgment |
|---|---|---|---|---|---|---|---|---|---|---|
| Fear of childbirth | ||||||||||
| 11 |
RCT Semi-experimental |
Serious | Serious | No serious | No serious | No serious | 534 | 604 | SMD 16.7 lower (23.5 lower to 9.9 lower) |
⊕⊕⊖⊖ low |
| Pain intensity in the first labour phase | ||||||||||
| 2 |
RCT* Semi-experimental |
Serious | No serious | No serious | No serious | No serious | 115 | 184 | SMD 2.3 lower (2.5 lower to 2.1lower) |
⊕⊕⊕⊖ Moderate |
| Pain intensity in the second labour phase | ||||||||||
| 2 |
RCT* Semi-experimental |
Serious | No serious | No serious | No serious | No serious | 115 | 184 | SMD 2.0 lower (2.3 lower to 1.8 lower) |
⊕⊕⊕⊖ Moderate |
| Postpartum depression | ||||||||||
| 4 |
RCT* Semi-experimental |
Serious | Serious | No serious | No serious | No serious | 208 | 224 | SMD 4.2 lower (5.9 lower to 2.5 lower) |
⊕⊕⊖⊖ Low |
| GRADE: Grading of Recommendations Assessment, Development and Evaluation; CI: confidence interval; RCT: randomized controlled trial; SMD: standardized mean difference | ||||||||||
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect is close to the effect estimate.
Moderate certainty: We are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: Our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect.
Very low certainty: We have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of the effect.