A Cochrane review included 12 studies with a total of 3 617 women and 3 628 babies. There was no difference in neonatal sepsis or infection, overall perinatal mortality (RR 1.76, 95% CI 0.89 to 3.50; 11 trials, n=3319), or intrauterine deaths when comparing early delivery with expectant management. Early delivery increased the incidence of respiratory distress syndrome, admission to neonatal intensive care, and caesarean section (table ), but decreased the risk of chorioamnionitis and maternal hospital stay (table ).
| Outcome | Relative effect (95% CI) | Assumed risk - Control - Expectant management | Corresponding risk - Intervention - Planned early birth (95% CI) | No of participants (studies) Quality of evidence |
|---|---|---|---|---|
| Neonatal infection/sepsis, Follow-up: 28 days | RR 0.93 (0.66 to 1.3) | 37 / 1000 | 34 / 1000 (24 to 48) | 3628 (12) Moderate |
| Neonatal respiratory distress syndrome, Follow-up: 28 days | RR 1.26 (1.05 to 1.53) | 84 / 1000 | 109 / 1000 (89 to 131) | 3622 (12) High |
| Need for ventilation | RR 1.27 (1.02 to 1.58) | 86 / 1000 | 110 / 1000 (88 to 136) | 2895 (7) High |
| Admission to neonatal intensive care, Follow-up: 28 days | RR 1.16 (1.08 to 1.24) | 428 / 1000 | 497 / 1000 (462 to 531) | 2691 (4) Moderate |
| Caesarean section | RR 1.26 (1.11 to 1.44) | 172 / 1000 | 217 / 1000 (191 to 248) | 3620 (12) High |
| Chorioamnionitis | RR 0.50 (0.26 to 0.95) | 103 / 1000 | 51 / 1000 (27 to 98) | 1358 (8) Moderate |
| Length of hospital stay (maternal) | MD -1.75 (-2.45 to -1.05) | The mean length of hospital stay was 7.6 days | The mean length of hospital stay was 1.75 days lower (2.45 to 1.05 lower) | 2848 (6) Moderate |