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Bed rest in singleton pregnancies for preventing preterm birth.

C Sosa, F Althabe, J Belizán

The Cochrane Database of Systematic Reviews

|February 20, 2004

Summary

Current evidence does not support bed rest for preventing preterm birth. Clinicians should discuss potential harms and benefits with high-risk patients, as routine advice lacks supporting data.

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Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine

Background:

Bed rest is commonly recommended to prevent preterm birth, based on the idea it reduces uterine activity.
However, potential adverse effects of bed rest on maternal and infant outcomes are a concern.

Purpose of the Study:

To evaluate the effectiveness of prescribed bed rest (in hospital or at home) for preventing preterm birth in high-risk pregnancies.

Main Methods:

Systematic review of randomized and quasi-randomized controlled trials.
Searched multiple databases including Cochrane, MEDLINE, EMBASE, LILACS, and POPLINE up to July 2003.
Two independent reviewers assessed eligibility, quality, and extracted data.

Main Results:

One study with 1266 women met inclusion criteria; methodological quality was uncertain.

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Preterm birth rates were similar between the bed rest group (7.9%) and the control group (8.5%).

No other clinical outcomes were reported.

Conclusions:

There is insufficient evidence to support or refute the use of bed rest for preventing preterm birth.
Despite widespread use, bed rest lacks proven benefits and may have adverse effects.
Clinicians should counsel high-risk women on potential benefits and harms, and further research is needed.