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. 2000;1996(2):CD000034.
doi: 10.1002/14651858.CD000034.

Bed rest in hospital for suspected impaired fetal growth

A M Gülmezoglu  1 , G J Hofmeyr
Affiliations

Bed rest in hospital for suspected impaired fetal growth

A M Gülmezoglu et al. Cochrane Database Syst Rev. 2000.

Abstract

Background: Bed rest in hospital or at home is widely advised for many complications of pregnancy. The increased clinical supervision needs to be balanced with the risk of thrombosis, the stress on the pregnant women, as well as the costs to families and health services.

Objectives: The objective of this review was to assess the effects of bed rest in hospital for women with suspected impaired fetal growth.

Search strategy: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: December 1999.

Selection criteria: Randomised trials comparing a policy of bed rest in hospital with ambulatory management for women with suspected impaired fetal growth.

Data collection and analysis: Trial quality was assessed.

Main results: One study involving 107 women was included. Allocation of treatment was by odd or even birth date. There were differences in baseline fetal weights and birth weights, but these were not statistically significant (mean estimated fetal weight deviation at enrolment was -21.7% for the bed rest group and -20.7% for the ambulatory group; mean estimated birth weight was -19.7% for the bed rest group and -20.6% for the ambulatory group). No differences were detected between bed rest and ambulatory management for fetal growth parameters (relative risk 0.43, 95% confidence interval: 0.15 to 1. 27) and neonatal outcomes.

Reviewer's conclusions: There is not enough evidence to evaluate the use of a bed rest in hospital policy for women with suspected impaired fetal growth.

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Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 Bed rest in hospital versus ambulatory management, Outcome 1 Operative delivery for fetal distress.
1.2
1.2. Analysis
Comparison 1 Bed rest in hospital versus ambulatory management, Outcome 2 1‐minute Apgar score < 8.
1.3
1.3. Analysis
Comparison 1 Bed rest in hospital versus ambulatory management, Outcome 3 5‐minute Apgar < 8.
1.4
1.4. Analysis
Comparison 1 Bed rest in hospital versus ambulatory management, Outcome 4 % birthweight deviation from expected.
See this image and copyright information in PMC

References

References to studies included in this review

Laurin 1987 {published data only}
    1. Laurin J, Persson PH. The effect of bedrest in hospital on fetal outcome in pregnancies complicated by intra‐uterine growth retardation. Acta Obstetricia et Gynecologica Scandinavica 1987;66:407‐11. - PubMed

Additional references

Bernstein 2000
    1. Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A. Morbidity and mortality among very low birth weight infants with intrauterine growth restriction. The Vermont Oxford Network. American Journal of Obstetrics and Gynecology 2000;182:198. - PubMed
Clarke 2000
    1. Clarke M, Oxman AD, editors. Cochrane Reviewers’ Handbook 4.1 [updated June 2000]. In: Review Manager (RevMan) [Computer program]. Version 4.1. Oxford, England: The Cochrane Collaboration, 2000.
Crowther 1995
    1. Crowther CA. Commentary: Bedrest for women with pregnancy problems: evidence for efficacy is lacking. Birth 1995;22:13‐4.
Lin 1998
    1. Lin C, Santolaya‐Forgas J. Current concepts of fetal growth restriction: Part 1. Causes, classification, and pathophysiology. Obstetrics & Gynecology 1998;92(6):1044‐55. - PubMed
Resnik 2002
    1. Resnik R. Intrauterine growth restriction. Obstetrics & Gynecology 2002;99(3):490‐6. - PubMed

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