Summary of findings for the main comparison. Interventionist care compared to expectant (delayed delivery) care for severe pre‐eclampsia for severe pre‐eclampsia between 24 and 34 weeks' gestation.
| Interventionist care compared to expectant (delayed delivery) care for severe pre‐eclampsia | ||||||
| Patient or population: women with severe pre‐eclampsia between 24 and 34 weeks' gestation Setting: hospital settings Intervention: interventionist care Comparison: expectant (delayed delivery) care | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with expectant (delayed delivery) care | Risk with Interventionist care | |||||
| Maternal death | Study population | not estimable | 320 (2 RCTs) | ⊕⊕⊝⊝ LOW a,b | There were no deaths in either group | |
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Eclampsia | Study population | RR 0.98 (0.06 to 15.58) | 359 (2 RCTs) | ⊕⊝⊝⊝ VERY LOW c,d | ||
| 6 per 1000 | 5 per 1000 (0 to 87) | |||||
| Stroke (brain damage) | ‐ | ‐ | ‐ | ‐ | ‐ | outcome not reported |
| HELLP syndrome | Study population | RR 1.09 (0.62 to 1.91) | 359 (2 RCTs) | ⊕⊕⊝⊝ LOW c,e | ||
| 111 per 1000 | 121 per 1000 (69 to 212) | |||||
| Pulmonary oedema | Study population | RR 0.45 (0.07 to 3.00) | 415 (3 RCTs) | ⊕⊝⊝⊝ VERY LOW c,f | ||
| 10 per 1000 | 4 per 1000 (1 to 29) | |||||
| Perinatal mortality or perinatal death | Study population | RR 1.11 (0.62 to 1.99) | 343 (3 RCTs) | ⊕⊕⊝⊝ LOW e,g | ||
| 105 per 1000 | 117 per 1000 (65 to 209) | |||||
| Intraventricular haemorrhage or hypoxic ischaemic encephalopathy | Study population | RR 1.94 (1.15 to 3.29) | 537 (2 RCTs) | ⊕⊕⊕⊝ MODERATE c | ||
| 66 per 1000 | 127 per 1000 (75 to 216) | |||||
| *The risk in the intervention group (and its 95% confidence interval) 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; HELLP syndrome: haemolysis, elevated liver enzymes, and low platelets. Hospital settings were in USA, South Africa, Egypt, The Netherlands, Latin America (Panama, Pennsylvania, Mexico, Venezuela, Guatemala, Peru, Ecuador), and Europe (Belgium, Cyprus, Czech Republic, Germany, Hungary, Greece, Italy, Netherlands, Poland, Portugal, Saudi Arabia, Slovenia, UK). | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect 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 effect | ||||||
a Limitations in study design (no blinding; ‐1)
b No events (‐1)
c Limitations in study design (no blinding) for one of the studies (‐1)
d Low event rate, small sample size and wide CI crossing the line of no effect (‐2)
e Wide CI crossing the line of no effect (‐1)
f Small number of events and wide CI crossing the line of no effect (‐2)
g Limitations in study design (‐1)