Comparison 1. Tranexamic acid versus placebo/no treatment.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Blood loss > 400 mL or > 500 mL	6	1398	Risk Ratio (M‐H, Random, 95% CI)	0.52 [0.42, 0.63]
1.1 Tranexamic acid in vaginal birth	3	832	Risk Ratio (M‐H, Random, 95% CI)	0.42 [0.28, 0.63]
1.2 Tranexamic acid in caesarean section	3	566	Risk Ratio (M‐H, Random, 95% CI)	0.55 [0.44, 0.69]
2 Blood loss > 1000 mL	6	2093	Risk Ratio (M‐H, Fixed, 95% CI)	0.40 [0.23, 0.71]
2.1 Tranexamic acid in vaginal birth	2	559	Risk Ratio (M‐H, Fixed, 95% CI)	0.28 [0.06, 1.36]
2.2 Tranexamic acid in caesarean section	4	1534	Risk Ratio (M‐H, Fixed, 95% CI)	0.43 [0.23, 0.78]
3 Mean blood loss (mL)	5	1186	Mean Difference (IV, Fixed, 95% CI)	‐77.79 [‐97.95, ‐57.64]
3.1 Tranexamic acid in vaginal birth	3	832	Mean Difference (IV, Fixed, 95% CI)	‐80.56 [‐104.80, ‐56.33]
3.2 Tranexamic acid in caesarean section	2	354	Mean Difference (IV, Fixed, 95% CI)	‐71.57 [‐107.89, ‐35.26]
4 Use of additional medical interventions to control PPH	5	2049	Risk Ratio (M‐H, Fixed, 95% CI)	0.48 [0.34, 0.68]
4.1 Tranexamic acid in vaginal birth	2	559	Risk Ratio (M‐H, Fixed, 95% CI)	0.35 [0.16, 0.72]
4.2 Tranexamic acid in caesarean section	3	1490	Risk Ratio (M‐H, Fixed, 95% CI)	0.54 [0.36, 0.81]
5 Use of additional surgical interventions to control PPH	4	2051	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.1 Tranexamic acid in vaginal birth	1	439	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Tranexamic acid in caesarean section	3	1612	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Blood transfusion	6	1698	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.11, 0.53]
6.1 Tranexamic acid in vaginal birth	1	439	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.03, 3.17]
6.2 Tranexamic acid in CS	5	1259	Risk Ratio (M‐H, Fixed, 95% CI)	0.23 [0.10, 0.54]
7 Maternal death or severe maternal morbidity such as seizure, thromboembolic events, need for intensive care unit admission, hysterectomy, organ failure	4	1511	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.1 Tranexamic acid in vaginal birth	2	559	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Tranexamic acid in caesarean section	2	952	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Side effects	8	2616	Risk Ratio (M‐H, Random, 95% CI)	2.48 [1.36, 4.50]
8.1 Tranexamic acid in vaginal birth	3	740	Risk Ratio (M‐H, Random, 95% CI)	1.96 [1.50, 2.55]
8.2 Tranexamic acid in caesarean section	5	1876	Risk Ratio (M‐H, Random, 95% CI)	3.78 [0.69, 20.66]
9 Thromboembolic events	11	3012	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.14, 6.78]
9.1 Tranexamic acid in vaginal birth	2	559	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Tranexamic acid for caesarean section	9	2453	Risk Ratio (M‐H, Fixed, 95% CI)	0.98 [0.14, 6.78]