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. 2020 Jul 15;2020(7):CD004945. doi: 10.1002/14651858.CD004945.pub5

Comparison 1. Labour induction versus expectant management (all trials).

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Perinatal death 22 18795 Risk Ratio (M‐H, Fixed, 95% CI) 0.31 [0.15, 0.64]
1.2 Stillbirth 22 18795 Risk Ratio (M‐H, Fixed, 95% CI) 0.30 [0.12, 0.75]
1.3 Neonatal death 21 18611 Risk Ratio (M‐H, Fixed, 95% CI) 0.39 [0.13, 1.14]
1.4 Birth asphyxia 4 1456 Risk Ratio (M‐H, Fixed, 95% CI) 1.66 [0.61, 4.55]
1.5 Admission to neonatal intensive care unit 17 17826 Risk Ratio (M‐H, Fixed, 95% CI) 0.88 [0.80, 0.96]
1.6 Neonatal convulsions 5 13216 Risk Ratio (M‐H, Random, 95% CI) 1.01 [0.15, 6.67]
1.7 Neonatal encephalopathy (HIE) 2 8851 Risk Ratio (M‐H, Fixed, 95% CI) 0.69 [0.37, 1.31]
1.8 Use of anticonvulsants 1 349 Risk Ratio (M‐H, Fixed, 95% CI) 0.34 [0.01, 8.17]
1.9 Meconium aspiration syndrome 13 16622 Risk Ratio (M‐H, Fixed, 95% CI) 0.75 [0.62, 0.92]
1.10 Pneumonia 2 8851 Risk Ratio (M‐H, Fixed, 95% CI) 0.54 [0.27, 1.06]
1.11 Apgar score less than 7 at 5 minutes 20 18345 Risk Ratio (M‐H, Fixed, 95% CI) 0.73 [0.56, 0.96]
1.12 Birthweight (g) 18 8817 Mean Difference (IV, Fixed, 95% CI) ‐59.38 [‐77.03, ‐41.73]
1.13 Birthweight > 4000 g 8 5593 Risk Ratio (M‐H, Random, 95% CI) 0.72 [0.54, 0.96]
1.14 Neonatal (birth) trauma 5 13106 Risk Ratio (M‐H, Fixed, 95% CI) 0.97 [0.63, 1.49]
1.15 Caesarean section 31 21030 Risk Ratio (M‐H, Fixed, 95% CI) 0.90 [0.85, 0.95]
1.16 Operative vaginal birth (forceps or ventouse) 22 18584 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.96, 1.10]
1.17 Analgesia used 12   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
1.17.1 Epidural/regional 8 4579 Risk Ratio (M‐H, Random, 95% CI) 1.09 [0.99, 1.20]
1.17.2 Other 4 2352 Risk Ratio (M‐H, Random, 95% CI) 1.11 [1.05, 1.18]
1.18 Perineal trauma 7   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.18.1 Severe perineal tear 5 11589 Risk Ratio (M‐H, Fixed, 95% CI) 1.04 [0.85, 1.26]
1.18.2 Episiotomy 2 1747 Risk Ratio (M‐H, Fixed, 95% CI) 0.96 [0.84, 1.11]
1.18.3 Obstetrical anal sphincter injuries 2 1698 Risk Ratio (M‐H, Fixed, 95% CI) 0.81 [0.51, 1.31]
1.19 Prolonged labour 4   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.19.1 First stage 2 648 Risk Ratio (M‐H, Fixed, 95% CI) 0.76 [0.49, 1.20]
1.19.2 Second stage 1 508 Risk Ratio (M‐H, Fixed, 95% CI) 0.67 [0.36, 1.22]
1.19.3 Third stage 1 249 Risk Ratio (M‐H, Fixed, 95% CI) 3.02 [0.12, 73.52]
1.19.4 No definition 1 112 Risk Ratio (M‐H, Fixed, 95% CI) 0.35 [0.01, 8.30]
1.20 Postpartum haemorrhage 9 12609 Risk Ratio (M‐H, Fixed, 95% CI) 1.02 [0.91, 1.15]
1.21 Breastfeeding 2 7487 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.96, 1.04]
1.22 Maternal satisfaction 3   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.22.1 Hoping to be randomised to the same trial arm as they had been in this study 1 496 Risk Ratio (M‐H, Fixed, 95% CI) 1.93 [1.62, 2.30]
1.22.2 Preferred/satisfied with their allocation 2 493 Risk Ratio (M‐H, Fixed, 95% CI) 0.99 [0.88, 1.13]
1.22.3 Satisfaction with pregnancy outcome 1 308 Risk Ratio (M‐H, Fixed, 95% CI) 0.92 [0.80, 1.06]
1.23 Maternal satisfaction 1 619 Mean Difference (IV, Fixed, 95% CI) 0.07 [‐0.02, 0.16]
1.24 Length of maternal hospital stay (days) 7 4120 Mean Difference (IV, Random, 95% CI) ‐0.19 [‐0.56, 0.18]
1.25 Length of maternal (postnatal) stay (categories) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.25.1 < 2 days 1 6096 Risk Ratio (M‐H, Fixed, 95% CI) 1.01 [0.87, 1.17]
1.25.2 2 days 1 6096 Risk Ratio (M‐H, Fixed, 95% CI) 1.04 [1.01, 1.08]
1.25.3 3 days 1 6096 Risk Ratio (M‐H, Fixed, 95% CI) 0.88 [0.77, 0.99]
1.25.4 4 days 1 6096 Risk Ratio (M‐H, Fixed, 95% CI) 0.78 [0.62, 0.97]
1.25.5 > 4 days 1 6096 Risk Ratio (M‐H, Fixed, 95% CI) 0.94 [0.48, 1.82]
1.26 Length of neonatal hospital stay (days) 1 302 Mean Difference (IV, Fixed, 95% CI) ‐0.30 [‐0.61, 0.01]
1.27 Length of neonatal (postnatal) stay (categories) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.27.1 ≤ 2 days 1 6091 Risk Ratio (M‐H, Fixed, 95% CI) 1.05 [1.02, 1.08]
1.27.2 ≥ 3 days 1 6091 Risk Ratio (M‐H, Fixed, 95% CI) 0.86 [0.79, 0.94]
1.28 Length of labour (hours) 12 4025 Mean Difference (IV, Random, 95% CI) ‐1.08 [‐1.67, ‐0.50]