Investigating the balance of reporting maternal and infant outcomes in pregnancy and childbirth Cochrane reviews

Am J Perinatol. 2014 Sep;31(8):689-94. doi: 10.1055/s-0033-1357266. Epub 2013 Oct 9.

Abstract

Objective: To summarize the overall conclusions of Cochrane Pregnancy and Childbirth Group (PCG) reviews where interventions have different effects on maternal and infant outcomes.

Methods: PCG reviews were analyzed and primary outcomes extracted and categorized by maternal and infant outcomes. The overall conclusions were categorized depending on whether they follow the benefit or harm for one group or are inconclusive due to the discrepancy.

Results: A total of 451 current PCG reviews were assessed out of which 206 were analyzed. In general, the overall conclusions of reviews followed both beneficial and harmful outcomes. Around 58 (28.2%) recommended the intervention, 60 (29.1%) discouraged the intervention, and 88 (42.7%) were inconclusive. Total 10 Reviews reported opposing maternal and fetal/neonatal outcomes. Six (60%) contained inconclusive final recommendations. Three of the remaining four (75%) had a summary recommendation following the fetal/neonatal outcome. We did not detect bias based on whether the author group was obstetric or pediatric providers.

Conclusion: The final author conclusions in PCG reviews generally follow the overall assessment of maternal and fetal/neonatal outcomes. There were, however, a large number of inconclusive final recommendations in PCG reviews. These findings highlight the fact that many interventions represent trade-offs between maternal and fetal outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Humans
  • Maternal Welfare*
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Outcome*
  • Review Literature as Topic*
  • Treatment Outcome