Table 2 Excluded High Quality Reviews Reporting Interventions with no effect
From: Public health interventions in midwifery: a systematic review of systematic reviews
| 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 |