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Table 4 GRADE summary of findings

From: A systematic review and time-response meta-analysis of the optimal timing of elective caesarean sections for best maternal and neonatal health outcomes

Outcome

№ of participants (studies)

Relative effect (95% CI)a

Anticipated absolute effects (95% CI)

Certainty

  

Difference

NICU admission

№ of participants: 898,272 (1RCT,13 observational studies)

RR 0.63 (0.56 to 0.71)

3.3%

2.1% (1.9 to 2.3)

1.2% fewer (1,5 fewer to 1 fewer)

LOW

Neonatal death

№ of participants: 533,503 (4 observational studies)

n/N IG: 274/25,8080 n/N CG: 160/27,5423 < 39 RR 0.59 (0.43 to 0.83) ≥39 RR 2.09 (1.18 to 3.70)

LOW

Respiratory morbidity

№ of participants: 57,693 (9 observational studies)

RR 0.64 (0.51 to 0.79)

2.6%

1.7% (1.3 to 2.1)

0.9% fewer (1.3 fewer to 0.5 fewer)

VERY LOW

Hospitalization ≥5 days

№ of participants: 59,331 (5 observational studies)

n/N IG: 2222/24,663 n/N CG: 3289/34,668 < 39 RR 0.52 (0.36 to 0.75) ≥39 RR 2.00 (1.40 to 2.86)

VERY LOW

Sepsis

№ of participants: 42,381 (4 observational studies)

n/N IG: 366/20,689 n/N CG: 318/21,692 < 39 RR 0.55 (0.44 to 0.67) ≥39 RR 3.57 (1.87 to 6.78)

LOW

Hypoglycemia

№ of participants: 46,367 (1 RCT, 5 observational studies)

RR 0.84 (0.79 to 0.91)

1.2%

1.0% (1.0 to 1.1)

0.2% fewer (0.3 fewer to 0.1 fewer)

MODERATE

Apgar Score < 7

№ of participants: 805,274 (5 observational studies)

RR 0.90 (0.69 to 1.17)

0.5%

0.5% (0.4 to 0.6)

0.1% fewer (0.2 fewer to 0.1 more)

VERY LOW

Jaundice

№ of participants: 32,109 (5 observational studies)

RR 0.71 (0.66 to 0.77)

2.3%

1.7% (1.5 to 1.8)

0.7% fewer (0.8 fewer to 0.5 fewer)

LOW

RDS

№ of participants: 43,888 (5 observational studies)

RR 0.60 (0.54 to 0.67)

0.7%

0.4% (0.4 to 0.5)

0.3% fewer (03 fewer to 0.2 fewer)

LOW

TTN

№ of participants: 40,766 (5 observational studies)

RR 0.68 (0.54 to 0.86)

2.5%

1.7% (1.4 to 2.2)

0.8% fewer (12 fewer to 0.4 fewer)

VERY LOW

Pneumothorax

№ of participants: 25,121 (4 observational studies)

RR 0.99 (0.03 to 39.19)

0.1%

0.1% (0.0 to 4.5)

0.0% fewer (0.1 fewer to 4.4 more)

VERY LOW

Maternal death

№ of participants: 14,865 (1 observational studies)

RR 0.38 (0.04 to 3.40)

0.0%

0.0% (0.0 to 0.2)

0.0% fewer (0.0 fewer to 0.1 more)

VERY LOW

Maternal hysterectomy

№ of participants: 18,662 (3 observational studies)

RR 1.10 (0.03 to 39.35)

0.2%

0.2% (0.0 to 7.9)

0.0% fewer (0.2 fewer to 7.7 more)

VERY LOW

Maternal blood transfusion№ of participants: 15,162 (2 observational studies)

RR 1.21 (0.02 to 65.67)

0.8%

1.0% (0.0 to 54.0)

0.2% more (0.8 fewer to 53.2 more)

VERY LOW

NICU admission only repeat CS

№ of participants: 527,941 (4 observational studies)

RR 0.66 (0.65 to 0.67)

3.0%

2.0% (2.0 to 2.0)

1.0% fewer (1.1 fewer to 1 fewer)

MODERATE

NICU death only repeat CS

№ of participants: 497,917

(2 observational studies)

n/N IG: 194/24,1683 n/N CG: 158/25,6234 < 39 RR 0.67 (0.51 to 0.87) ≥39 RR 1.68 (1.07 to 2.65)

VERY LOW

  1. atime response with reference category 39 week of gestation (RR = 1)
  2. CI Confidence Interval; CG Control group; IG Intervention group; n Number of events; N Number of participants; RCT Randomized controlled trial; RDS Respiratory distress syndrome; RR Relative risk; TTN Transient tachypnea of the newborn