Summary of findings 2. Partial bed rest with or without hospitalisation in multiple pregnancy for improving outcomes.
| Population: women with multiple pregnancy Setting: Australia, Zimbabwe Intervention: partial bed rest in hospital Comparison: no activity restriction at home | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with no activity restriction at home | Risk with partial bed rest in hospital | |||||
| Very preterm birth (less than 34 weeks) ‐ assuming complete correlation between twins | Study population | RR 2.30 (0.84 to 6.27) | 141 (1 RCT) | ⊕⊕⊝⊝ Low 1,2 | ||
| 69 per 1000 | 160 per 1000 (58 to 435) | |||||
| Perinatal mortality ‐ assuming independence between twins | Study population | RR 4.17 (0.90 to 19.31) | 282 (1 RCT) | ⊕⊕⊝⊝ Low 1,2 | ||
| 14 per 1000 | 58 per 1000 (12 to 268) | |||||
| Low birthweight (less than 2500 g) ‐ assuming independence between twins/triplets | See comments | No studies reported this outcome | ||||
| Prelabour preterm rupture of the membrane | Study population | RR 1.51 (0.69 to 3.30) | 141 (1 RCT) | ⊕⊕⊝⊝ Low 1,2 | ||
| 125 per 1000 | 189 per 1000 (86 to 413) | |||||
| Small‐for‐gestational age ‐ assuming independence between twins | Study population | RR 0.93 (0.69 to 1.26) | 282 (1 RCT) | ⊕⊕⊝⊝ Low 1,2 | ||
| 389 per 1000 | 362 per 1000 (268 to 490) | |||||
| Psychosocial effects of bed rest (depression, anxiety, stress) | See comments | No studies reported this outcome | ||||
| *The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: 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 quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 Very wide 95% CI with very small number of events (‐2). 2 We did not downgrade for the lack of blinding due to the outcomes was not likely to be influenced by lack of blinding.