Prenatal bed rest in developed and developing regions: a systematic review and meta-analysis
Bibliographic record
Abstract
<h3>Background:</h3> Bed rest is prescribed by most maternity health care professionals for high-risk pregnancy complications, but the impact of bed rest at home and in hospital has not been explored. Our aim was to quantify the influence of bed rest on maternal/fetal health outcomes in developed and developing regions. <h3>Methods:</h3> We conducted a systematic review and meta-analysis of randomized controlled trials. We conducted a structured search through MEDLINE, Embase, CINAHL, Web of Science and the Cochrane Library through Mar. 7, 2019. Trials comparing standard care to standard care plus bed rest after 20 weeks’ gestation were assessed. Outcomes included infant birth weight, being small for gestational age, gestational age, premature or very premature birth, perinatal death, admission to the neonatal intensive care unit, preterm rupture of membranes, hypertensive disorders of pregnancy, preeclampsia and gestational diabetes mellitus. <h3>Results:</h3> We identified 1191 publications, of which 43 were assessed for eligibility. Sixteen publications reporting on 14 unique studies (2608 women, 3328 infants) were included in the analysis. Overall, maternal/newborn outcomes were similar between women on bed rest and those not on bed rest. In subgroup analyses of developed and developing regions, length of gestation was shorter with bed rest (weighted mean difference −0.77 wk, 95% confidence interval [CI] −1.26 to −0.27, <i>I</i><sup>2</sup> = 0%), and the risk of a very premature birth was increased (risk ratio 2.07, 95% CI 1.15 to 3.73, <i>I</i><sup>2</sup> = 0%) in developed countries. <h3>Interpretation:</h3> In developed regions, treatment of complicated pregnancies with more than 1 week of bed rest results in worse newborn outcomes. Additional studies are required to determine whether bed rest or hospital admission improves outcomes in developing regions. <b>PROSPERO Trial registration number:</b> CRD42018099237.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.013 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".