Table 2 Randomised controlled trials included in the systematic review and meta-analysis
Study | Population | Intervention | Comparison | Outcome measures | Setting | Timing | Decisional conflict mean difference score (95% CI) | Change in women’s knowledge |
|---|---|---|---|---|---|---|---|---|
Pre-existing medical conditions | ||||||||
Prunty (2008) [14] RCT | Pre-pregnancy women with multiple sclerosis | Paper decision aid booklet IPDAS compliant | Usual care physician care | Primary end: knowledge, DCS Secondary: self-efficacy, certainty, value congruence, bias. | Australian health system. Aid delivered at home or by researcher, not as part of usual care. | Pre-survey - anytime pre-pregnancy. Post survey within 3 weeks. | −5.50 (−10.54, −0.46) | Decision aid increased women’s knowledge |
Meade et al. 2015 [15] RCT | Pre-pregnancy and pregnant women with rheumatoid arthritis | Paper decision aid booklet IPDAS compliant | Usual care physician and antenatal care | Primary: Knowledge and DCS; Secondary: Self efficacy, depression, and anxiety. | Australian health system. Aid delivered at home or by researcher, not as part of usual care. | Pre-survey -anytime pre-pregnancy or during pregnancy. Post survey within 12 weeks. | −6.66 (−13.28, − 0.04) | Decision aid increased women’s knowledge |
McGrath et al. 2017 [16] RCT | Pre-pregnancy women with epilepsy | Paper decision aid booklet IPDAS compliant | Usual care physician care | Primary: knowledge and DCS Secondary: self-efficacy, certainty, value congruence, bias. | Australian health system. Aid delivered at home or by researcher, not as part of usual care. | Pre-survey - anytime pre-pregnancy. Post survey within 3 weeks. | −10.98 (−21.78, − 0.18) | Decision aid increased women’s knowledge |
Vigod et al. 2019 Pilot [17] RCT | Pre-pregnancy and pregnant women with depression | Computerised decision aid IPDAS compliant | Usual care from specialist perinatal mental health care and non-specialist antenatal care plus online information sheet | Primary: Acceptability; Secondary: DCS, PND and Anxiety | Canadian health system. Aid delivered at home or by researcher, not as part of usual care. | Pre survey – anytime. Post survey within 4 weeks. | −7.50 (− 15.23, 0.23) | Decision aid increased women’s knowledge |
Khalifeh et al. 2019 Pilot [18] RCT | Pre-pregnancy and pregnant women with depression | Computerised decision aid IPDAS compliant | Usual care from specialist perinatal mental health care and non-specialist antenatal care plus online information sheet | DCS | United Kingdom health system. Aid delivered at home or by researcher, not as part of usual care. | Pre survey – anytime. Post survey within 4 weeks. | −5.30 (− 14.95, 4.35) | No improvement detected |
Pre-existing surgical conditions | ||||||||
Shorten et al. 2005 [19] RCT | Pregnant women with one previous caesarean section | Paper decision aid booklet IPDAS compliant | Usual routine antenatal care. | Primary: DC Sand knowledge; Secondary: congruity of decision and outcome. | Australian private obstetric practice. Aid delivered at home or by researcher, not as part of usual care. | Pre survey 12–18 weeks pregnant. Post survey 28 and 36 weeks pregnant. | −6.00 (− 10.26, − 1.74) | Decision aid increased women’s knowledge |
Montgomery et al. 2007 [20] Three-arm RCT | Pregnant women with one previous caesarean section. | Computerised analysis tool performed in birth choices clinic. IPDAS compliant | Usual routine antenatal care with birth choices clinic. | Primary: DCS, and mode of delivery. Secondary: knowledge, anxiety, and satisfaction. | United Kingdom national healthcare. Aid delivered at home or by researcher, not as part of usual care. | Pre survey between 20 and 36 weeks pregnant. Post survey after 37 weeks pregnant. | −4.20 9–6.88, − 1.54) Decision aid increased women’s knowledge | |
Eden et al. 2014 [21] RCT | Pregnant women with one previous caesarean section. | Interactive computerised decision aid in English and Spanish. IPDAS compliant | ACOG paper information brochure in English and Spanish | Primary: DCS. Secondary: compared birth intentions and final delivery Outcomes. | United States of America. Private healthcare. Non and insured healthcare. Aid delivered at home or by researcher, not as part of usual care. | Pre survey anytime during pregnancy. Post survey same day. | −3.40 (− 8.49, − 1.69) | Decision aid increased women’s knowledge |
Wise et al. 2019 [22] RCT | Pregnant women with one previous caesarean section attending a vaginal birth after caesarean section clinic. | Paper decision aid booklet IPDAS compliant | Usual care from specialist birth choices clinic | Primary: preferences for mode of birth and adherence to preferences. Secondary: DCS, knowledge, and maternal satisfaction. | New Zealand healthcare system. Aid read at home and followed up by specialist service. | Pre survey < 25 weeks pregnant. Post survey > 34 weeks pregnant. | 0.00 (− 3.38, 3.38) | Decision aid increased women’s knowledge |
Kupperman et al. 2020 [23] RCT | Pregnant women with one previous caesarean section attending a specialist birth after caesarean section clinic. | Computerised decision aid with a validated risk predictor based on demographics in English and Spanish. IPDAS compliant | Usual care from specialist birth choices clinic. | Primary: Delivery approach. Secondary: vaginal birth, maternal and neonatal morbidity as well as DCS, knowledge, decision efficacy, and decision satisfaction. | United States of America. University hospitals and community antenatal clinics. Aid delivered at home or by researcher, not as part of usual care. | Pre survey 25 weeks pregnant. Post survey 34–37 + 6 weeks pregnant. | −0.30 (− 1.67, 1.07) | Decision aid increased women’s knowledge |