Table 14 Impact of home versus hospital-based bed rest and monitoring in high-risk pregnancy on stillbirth and perinatal mortality
From: Reducing stillbirths: screening and monitoring during pregnancy and labour
Source | Location and Type of Study | Intervention | Stillbirths/Perinatal Outcomes |
|---|---|---|---|
Reviews and meta-analyses | |||
Crowther 2001 [127] | Zimbabwe, Finland, Australia. Meta-analysis (Cochrane). 6 RCTs included (N = 1431 women). | Compared pregnancy outcomes among women with a multiple pregnancy and their babies who were offered bed rest in hospital (intervention) vs. admission to hospital only if complications occurred (controls). | SBR: OR = 0.89 (95% CI: 0.43–1.85) [NS]. [14/698 vs. 16/733 in intervention and control groups, respectively]. PMR: OR = 1.14 (95% CI: 0.65–2.01) [NS]. [26/694 vs. 24/733 in intervention and control groups, respectively]. |
Meher et al. 2005 [130] | Zimbabwe. Cochrane review. 1 RCT included (N = 218 women). | To assess the effects on the mother and the baby of some bed rest in hospital (intervention) vs. routine activity at home (controls) for primary treatment of hypertension during pregnancy. | SBR: RR = 4.91 (95% CI: 0.24–101.10) [NS]. [2/110 vs. 0/108 in intervention and control groups, respectively]. PMR: RR = 1.96 (95% CI: 0.18–21.34) [NS]. [2/110 vs. 1/108 in intervention and control groups, respectively]. |
Intervention studies | |||
Monincx et al. 1997 [131] | The Netherlands (Amsterdam). The Academic Medical Centre. RCT. N = 150 women recruited between September 1992 and June 1994 (N = 76 intervention group, N = 74 controls). | To compare the outcomes of high-risk pregnancy monitored antenatally at home via domiciliary care (intervention) vs. hospital admission (controls). | SBR: 1/77 (1%) vs. 0/74 in intervention and control groups, respectively. PMR: 1/77 vs. 1/74 in intervention and control groups, respectively. |
[No authors listed] 1990 [132] | China (Shanhai). 6 hospitals. RCT. Women (N = 13006) of at least 30 wks' gestation (N = 6,506 intervention group, N = 6,500 controls). | Compared the impact on PMR of self-monitoring at home (intervention) vs. controls (without self-monitoring). | PMR: 6.30% vs. 10.92% in intervention and control groups, respectively (statistically significant). Fetal death (miscarriage + SB): 3.23% vs. 6.34% in intervention and control groups, respectively (statistically significant). |