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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. caroline.crowther@adelaide.edu.au

The Cochrane Database of Systematic Reviews
|May 2, 2001
PubMed
Summary

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

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Neonatology

Background:

  • Historically, bed rest in hospital was a common recommendation for women with multiple pregnancies.
  • This practice aimed to prevent preterm birth and improve fetal, neonatal, and maternal outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of hospital bed rest for women with multiple pregnancies.
  • To assess its impact on preventing preterm birth, perinatal mortality, and other adverse outcomes.

Main Methods:

  • Systematic review of randomized controlled trials comparing hospital bed rest with standard care for multiple pregnancies.
  • Searches conducted in Cochrane databases and reference lists up to August 2000.
  • Inclusion criteria focused on women with multiple pregnancies and their infants.

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Main Results:

  • Overall, routine bed rest did not decrease preterm birth or perinatal mortality.
  • A trend towards reduced low birth weight infants was observed, becoming significant after excluding one trial.
  • 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 observed but were not statistically significant.
  • For complicated twin pregnancies, no differences in preterm birth or perinatal outcomes were found.

Conclusions:

  • Insufficient evidence supports routine hospital bed rest for multiple pregnancies.
  • The policy is not recommended for routine clinical practice due to lack of proven benefits and potential harms.
  • Hospital bed rest for uncomplicated twin pregnancies may be detrimental, increasing the risk of very preterm birth.