Table 2 Excluded High Quality Reviews Reporting Interventions with no effect

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