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Hospitalisation and bed rest for multiple pregnancy.

C A Crowther1

  • 1Department of Obstetrics and Gynaecology, University of Adelaide, Women's and Children's Hospital, King William Road, Adelaide, South Australia, Australia, SA 5006. ccrowthe@medicine.adelaide.edu.au

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary

Routine hospital bed rest for multiple pregnancies does not prevent preterm birth or perinatal death. For uncomplicated twin pregnancies, it may increase the risk of very preterm birth, and is not recommended.

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Area of Science:

  • Maternal-Fetal Medicine
  • Neonatal Outcomes
  • Evidence-Based Practice

Background:

  • Historically, hospital bed rest was a common recommendation for women with multiple pregnancies.
  • The efficacy and safety of this intervention for preventing adverse outcomes have been questioned.

Purpose of the Study:

  • To evaluate the effectiveness of hospital bed rest in multiple pregnancies.
  • To assess its impact on preterm birth, fetal, neonatal, and maternal outcomes.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials were conducted.
  • Searches included the Cochrane Pregnancy and Childbirth Group trials register and other relevant databases up to January 1999.
  • Trials compared outcomes for women with multiple pregnancies on hospital bed rest versus those admitted only for complications.

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Main Results:

  • Overall, routine bed rest did not reduce preterm birth or perinatal mortality.
  • A trend towards decreased low birth weight infants was observed, significant when one trial was excluded.
  • For uncomplicated twin pregnancies, bed rest increased the risk of very preterm birth and showed no benefit in perinatal mortality.
  • For triplet pregnancies, potential benefits were noted but were not statistically significant.
  • For complicated twin pregnancies, no differences in preterm birth or perinatal mortality were found.

Conclusions:

  • Insufficient evidence supports routine hospital bed rest for multiple pregnancies.
  • The policy is not recommended for clinical practice due to lack of demonstrated benefit and potential harm in specific cases.
  • Further research is needed to clarify any potential benefits, such as improved fetal growth.