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.