Table 1 Quality assessment of trials of elective induction of labour versus expectant management for post-term pregnancies
| Â | Quality Assessment | Summary of Findings | ||||||
|---|---|---|---|---|---|---|---|---|
| Â | Â | Â | Â | Directness | No of events | Â | ||
No of studies (ref) | Design | Limitations | Consistency | Generalizability to population of interest | Generalizability to intervention of interest | Intervention | Control | Relative Risk (95% CI) |
Mortality (Stillbirth): 'MODERATE' outcome specific quality | ||||||||
14 | All RCTs; only 4 out of 14 RCTs report estimable differences in stillbirth between the two groups | Small sample size in 12 studies; result statistically insignificant; wide CI: low precision | All studies are consistent in showing a tendency towards reduction of stillbirth as an outcome i.e. the direction of effect is towards benefit | 5 in developing countries; rest in developed | Yes | 0 | 4 | RR (fixed): 0.29 (0.06 - 1.38) |
Mortality (Perinatal mortality): 'MODERATE' outcome specific quality | ||||||||
14 | All RCTs; only 8 out of 14 RCTs report estimable differences in perinatal mortality between the two groups | Small sample size in 12 studies | All studies are consistent in showing a tendency towards reduction in perinatal mortality as an outcome i.e. the direction of effect is towards benefit | 5 in developing countries; rest in developed | Yes | 1 | 10 | RR (fixed): 0.31 (0.11 - 0.88) |
Serious morbidity (Meconium aspiration syndrome):'MODERATE' outcome specific quality | ||||||||
7 | All RCTs | Small sample sizes in all studies | Consistent with 5/7 studies showing direction of benefit | 3 out of 7 in developing countries | Yes | 14 | 33 | RR (fixed): 0.43 (0.23 - 0.79) |
Serious morbidity (Birth asphyxia): 'MODERATE' outcome specific quality | ||||||||
2 | RCTs | Small sample sizes | Both the studies show a direction towards increased risk | 1/2 in developing countries | Yes | 6 | 3 | RR (fixed): 1.86 (0.51 - 6.76) |
Mild morbidity (Macrosomia): 'MODERATE' outcome specific quality | ||||||||
7 | All RCTs | Small sample sizes except in one study | 6/7 studies showing direction of benefit i.e. consistent | 2/7 in developing countries | Yes | 279 | 383 | RR (random): 0.72 (0.54 - 0.98) |