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Table 1 Characteristics of the included reviews on childbirth and postnatal interventions

From: Essential childbirth and postnatal interventions for improved maternal and neonatal health

Reviews

Objective

Type of Studies included (number)

Cochrane/non-Cochrane

Pooled Data (Y/N)

Outcomes reported

Hotnett 2013[10]

To assess the effects of continuous, one-to-one intrapartum support compared with usual care.

RCTs: 21

Cochrane

Yes

spontaneous vaginal birth, intrapartum analgesia, dissatisfaction, caesarean, instrumental vaginal birth, regional analgesia

Smail 2010[16]

To assess the effects of prophylactic antibiotics compared with no prophylactic antibiotics on infectious complications in women undergoing cesarean section.

RCTs and qRCTs: 86

Cochrane

Yes

febrile morbidity, wound infection, endometritis and serious maternal infectious complications

Cotter 2001[21]

To examine the effect of oxytocin given prophylactically in the third stage of labour on maternal and neonatal outcomes.

RCTs: 14

Cochrane

Yes

Blood loss, removal of placenta, blood pressure

Soltani 2010[22]

To assess the effect of the timing of administration of prophylactic uterotonics (before compared to after placental delivery) on the outcomes related to the third stage of labour.

RCTs: 3

Cochrane

Yes

postpartum haemorrhage, retained placenta, length of third stage of labour, postpartum blood loss, changes in haemoglobin, blood transfusion; the use of additional uterotonics the incidence of maternal hypotension and the incidence of severe postpartum haemorrhage

McDonald 2004[25]

To compare the effects of ergometrine-oxytocin with oxytocin in reducing the risk of PPH (blood loss of at least 500 ml) and other maternal and neonatal outcomes.

RCTs: 6

Cochrane

Yes

blood loss of at least 500 m

Begley 2011[24]

To compare the effectiveness of active versus expectant management of the third stage of labour.

RCTs and qRCTs: 5

Cochrane

Yes

maternal primary haemorrhage, maternal haemoglobin

McDonald 2013[26]

To determine the effects of early cord clamping compared with late cord clamping after birth on maternal and neonatal outcomes

RCTs:15

Cochrane

Yes

postpartum haemorrhage

Pena-Marti 2007[27]

To determine the efficacy of fundal pressure versus controlled cord traction as part of the active management of the third stage of labour.

RCTs: 0

Cochrane

No

None

Gulmezoglu 2012[30]

To evaluate the benefits and harms of a policy of labour induction at term or post-term compared to awaiting spontaneous labour or later induction of labour.

RCTs: 19

Cochrane

Yes

perinatal deaths, cesarean sections

Hussain 2011[31]

The purpose of this review was to study the possible impact of induction of labour (IOL) for post-term pregnancies compared to expectant management on stillbirths.

Studies: 25

RCTs: 14

Non-Cochrane

Yes

Stillbirths

Hofmeyr 2013[33]

To determine the effectiveness of uterine massage after birth and before or after delivery of the placenta, or both, to reduce postpartum blood loss and associated morbidity and mortality.

RCTs: 2

Cochrane

No

Blood loss

Tuncalp 2012[34]

To assess the effects of prophylactic prostaglandin use in the third stage of labour.

RCTs: 72

Cochrane

Yes

severe PPH, blood transfusion

Mousa 2007[35]

To assess the effectiveness and safety of pharmacological, surgical and radiological interventions used for the treatment of primary PPH

RCTs: 3

Cochrane

Yes

maternal mortality, hysterectomy, use of uterotonics, blood transfusion, or evacuation of retained products, maternal pyrexia

Lopez 2010[39]

Assess the effects of educational interventions for postpartum mothers about contraceptive use

RCTs: 8

Cochrane

Yes

effect on contraceptive use

Dodd 2004[45]

To assess the clinical effects of treatments for postpartum anaemia, including oral, intravenous or subcutaneous iron/folate supplementation and erythropoietin administration, and blood transfusion.

RCTs: 6

Cochrane

Yes

lactation at discharge from hospital

French 2004[46]

The effect of different antibiotic regimens for the treatment of postpartum endometritis on failure of therapy and complications was systematically reviewed.

RCTs: 47

Cochrane

Yes

treatment failures

Kesho Bora 2009[47]

Triple-antiretroviral (ARV) prophylaxis during pregnancy and breastfeeding compared to short-ARV prophylaxis to prevent mother-to-child transmission of HIV-1 (PMTCT): the Kesho Bora randomized controlled clinical trial in five sites in Burkina Faso, Kenya

1 study in five different location

Non Cochrane

No

Extended triple ARV regimen consisting of the anti-HIV drugs zidovudine, lamivudine andlopinavir/ritonavir, from the last trimester of pregnancy and continued during breastfeeding up to the age of six months.

McCall 2010[49]

To assess efficacy and safety of interventions designed for prevention of hypothermia in preterm and/or low birthweight infants applied within ten minutes after birth in the delivery suite compared with routine thermal care.

RCTs: 6

Cochrane

Yes

heat losses in infants < 28 weeks' gestation, risk of death within hospital stay

Dyson 2005[52]

To evaluate the effectiveness of interventions which aim to encourage women to breastfeed in terms of changes in the number of women who start to breastfeed.

RCTs: 7

Cochrane

Yes

increasing breastfeeding initiation rates

Lewin 2010[53]

To assess the effects of LHW interventions in primary and community health care on maternal and child health and the management of infectious diseases.

RCTs: 82

Cochrane

Yes

increasing breastfeeding initiation rates

Lassi 2010[54]

To assess the effectiveness of community-based intervention packages in reducing maternal and neonatal morbidity and mortality; and improving neonatal outcomes.

RCTs and qRCTs: 18

Cochrane

Yes

Maternal mortality, neonatal mortality, perinatal morality, stillbirths, newborn care practices

Imdad 2011[55]

To assess the effectiveness of breastfeeding promotion interventions on breastfeeding rates in early infancy.

RCTs and qRCTs: 53

Non-Cochrane

Yes

EBF at 4-6 weeks postpartum

Debes 2013[56]

To review the evidence for early breastfeeding initiation practices and to estimate the associationbetween timing and neonatal outcomes.

prospective studies,includingRCTs, and cohort studies = 18

Non-Cochrane

Yes

All-cause neonatal mortality, infection-related neonatal mortality

Lumbiganon 2011[57]

To evaluate the effectiveness of antenatal BF education for increasing BF initiation and duration.

RCTs: 17

Cochrane

No

BF educational interventions were not significantly better than a single intervention

Imdad 2013[62]

To evaluate the effects of application of chlorhexidineto the umbilical cord to children born in low income countries on cord infection (omphalitis) and neonatal mortality.

3 RCTs

Non-Cochrane

Yes

All cause neonatal mortality, omphalitis

Zupan 2004[60]

To assess the effects of topical cord care in preventing cord infection, illness and death.

RCTs and qRCTs: 21

Cochrane

Yes

colonization with antibiotics

Ziino 2002[67]

To determine if the administration of epinephrine to apparently stillborn and extremely bradycardic newborns reduces mortality and morbidity

RCTs: 0

Cochrane

No

-

Lee 2011[68]

To estimate the mortality effect of immediate newborn assessment and stimulation, and basic resuscitation on neonatal deaths due to term intrapartum-related events or preterm birth, for facility and home births.

RTs: 2

qRCT: 2

Observational studies: 20

Non-Cochrane

Yes

preterm birth

Ungerer 2004[69]

To assess the effect of prophylactic versus selective antibiotic treatment for asymptomatic term neonates born to mothers with risk factors for neonatal infection.

RCTs: 2

Cochrane

No

-

Mtitimila 2004[72]

To compare effectiveness and adverse effects of antibiotic regimens for treatment of presumed early neonatal sepsis.

RCTs: 2

Cochrane

Yes

Mortality, treatment failure or bacteriological resistance.

Gordon 2005[73]

To compare the effectiveness and adverse effects of different antibiotic regimens for treatment of suspected late onset sepsis in newborn infants.

RCTs:13

Cochrane

No

Mortality, treatment failure

Sazawal 2003[74]

This meta-analysis provides estimates of mortality impact of the case-management approach proposed by WHO.

RCTs: 7

Non-Cochrane

Yes

All-cause mortality, pneumonia specific mortality

Zaidi 2011[75]

We conducted systematic searches of multiple databases to identify relevant studies with mortality data.

RCTs: 7

Non-Cochrane

Yes

All-cause mortality, pneumonia specific mortality

Bhutta 2009[76]

We reviewed available evidence for community-based antibiotic management strategies for serious neonatal infections.

RCTs:9

Non-Cochrane

Yes

All-cause mortality, pneumonia specific mortality

Lawn 2010[79]

to review the evidence, and estimate the effect of KMC on neonatal mortality due to complications of preterm birth.

RCTs:9

Observational studies: 5

Non-Cochrane

Yes

neonatal mortality

Conde-Agudelo 2011[80]

To determine whether there is evidence to support the use of KMC in LBW infants as an alternative to conventional care after the initial period of stabilization with conventional care.

RCTs:3

Cochrane

Yes

nosocomial infection, severe illness, lower respiratory tract, not exclusively breastfeeding at discharge, and maternal dissatisfaction

Edmond 2006[84]

This review summarizes the evidence on feeding LBW infants and serves as the basis for the development of guidelines on feeding LBW infants in developing countries.

Systematic reviews, RCTs, observational studies and descriptive studies

Non-Cochrane

No

What to feed and optimal duration of breastfeeding

Soll 2009[86]

To determine the effect of multiple doses of exogenous surfactant compared to single doses of exogenous surfactant on mortality and complications of prematurity in premature infants at risk for or having respiratory distress syndrome.

RCTs:3

Cochrane

Yes

pneumothorax and risk of mortality

Soll 1998[92]

o assess the effect of intratracheal administration of synthetic surfactant in premature newborns with established respiratory distress syndrome (RDS).

RCTs:6

Cochrane

Yes

Pneumothorax, pulmonary interstitial emphysema, patent ductusarteriosus, risk of intraventricular hemorrhage, risk of bronchopulmonary dysplasia, risk of neonatal mortality

Soll 2012[93]

To compare the effects of early vs. delayed selective surfactant therapy for newborns intubated for respiratory distress within the first two hours of life. Planned subgroup analyses include separate comparisons for studies utilizing natural surfactant extract and synthetic surfactant.

RCTs:4

Cochrane

Yes

pneumothorax and pulmonary interstitial emphysema

Greenough 2008[98]

To compare the efficacy of: (i) synchronized mechanical ventilation, delivered as high frequency positive pressure ventilation (HFPPV) or patient triggered ventilation - assist control ventilation (ACV) or synchronous intermittent mandatory ventilation (SIMV)) with conventional ventilation (CMV) (ii) different types of triggered ventilation (ACV, SIMV, pressure regulated volume control ventilation (PRVCV) and SIMV plus pressure support (PS)

RCTs:14

Cochrane

Yes

Air leak, duration of ventilation, duration of weaning

Lemyre 2002[99]

In preterm infants with recurrent apnea, does treatment with NIPPV lead to a greater reduction in apnea and need for intubation and mechanical ventilation, as compared with treatment with NCPAP? Does NIPPV increase the incidence of gastrointestinal complications, i.e. gastric distension leading to cessation of feeds, or perforation?

RCTs:2

Cochrane

Yes

rates of apnea

Ho 2002[100]

In spontaneously breathing preterm infants with RDS, to determine if continuous distending pressure (CDP) reduces the need for IPPV and associated morbidity without adverse effects

RCTs:6

Cochrane

No

blood used for exchange transfusion

Thayyil 2006[102]

To compare the effectiveness of single volume exchange transfusion (SVET) with that of double volume exchange transfusion (DVET) in producing survival without disability and reducing bilirubin levels in newborn infants with severe jaundice.

RCTs:1

Cochrane

Yes

blood used for exchange transfusion

Mills 2001[101]

To evaluate the efficacy of fibreoptic phototherapy.

RCTs:31

Cochrane

Yes

serum bilirubin