Evidence map›Paper›PMID 30697855›Full record

SynthesisUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2019

Delivery or expectant management for prevention of adverse maternal and neonatal outcomes in hypertensive disorders of pregnancy: an individual participant data meta-analysis.

T P Bernardes, E F Zwertbroek, K Broekhuijsen, C Koopmans, K Boers, M Owens, J Thornton, M G van Pampus, S A Scherjon, K Wallace and 5 more

Erratum issuedOpen access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
11.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.

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  19. FIGO good practice recommendations on modifiable causes of iatrogenic preterm birth.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 8 institutions in 4 countries.

T P BernardesEpidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
E F ZwertbroekObstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0002-2416-9973
K BroekhuijsenObstetrics, Leiden University Medical Center, Leiden, The Netherlands.
C KoopmansObstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
K BoersObstetrics and Gynaecology, Bronovo Hospital, The Hague, The Netherlands.
M OwensObstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MI, USA.
J ThorntonObstetrics and Gynaecology, University of Nottingham, Nottingham, UK.
M G van PampusObstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
S A ScherjonObstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
K WallaceObstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MI, USA.
J LangenveldObstetrics and Gynaecology, Zuyderland Medical Centre, Heerlen, The Netherlands.
P P van den BergObstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
M T M FranssenObstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
B W J MolObstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.ORCID https://orcid.org/0000-0001-8337-550X
H GroenEpidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
University Medical Center Groningen · NLUniversity of Mississippi Medical Center · USBronovo Hospital · NLLeiden University Medical Center · NLMonash University · AUOLVG · NLUniversity of Nottingham · GBZuyderland Medisch Centrum · NL

Funding

Role of obesity in preeclamptic pregnancy.P20GM121334 · NIGMS · UNIVERSITY OF MISSISSIPPI MED CTR · PI Babbette LaMarca, Jane F Reckelhoff · 2017 to 2026
$26.4M
Gender and susceptibility to kidney damage in high BP.R01HL069194 · NHLBI · UNIVERSITY OF MISSISSIPPI MEDICAL CENTER · PI RECKELHOFF, JANE F · 2001 to 2010
$2.5M
NHLBI NIH HHS R01 HL069194NIGMS NIH HHS P20 GM121334
6 · The paper itself

Abstract

objectiveHypertensive disorders affect 3-10% of pregnancies. Delayed delivery carries maternal risks, while early delivery increases fetal risk, so appropriate timing is important. The aim of this study was to compare immediate delivery with expectant management for prevention of adverse maternal and neonatal outcomes in women with hypertensive disease in pregnancy.

methodsCENTRAL, PubMed, MEDLINE and ClinicalTrials.gov were searched for randomized controlled trials comparing immediate delivery to expectant management in women presenting with gestational hypertension or pre-eclampsia without severe features from 34 weeks of gestation. The primary neonatal outcome was respiratory distress syndrome (RDS) and the primary maternal outcome was a composite of HELLP syndrome and eclampsia. The PRISMA-IPD guideline was followed and a two-stage meta-analysis approach was used. Relative risks (RR) and numbers needed to treat or harm (NNT/NNH) with 95% CI were calculated to evaluate the effect of the intervention.

resultsMain outcomes were available for 1724 eligible women. Compared with expectant management, immediate delivery reduced the composite risk of HELLP syndrome and eclampsia in all women (0.8% vs 2.8%; RR, 0.33 (95% CI, 0.15-0.73); I

conclusionIn women with hypertension in pregnancy, immediate delivery reduces the risk of maternal complications, whilst the effect on the neonate depends on gestational age. Specifically, women with a-priori higher risk of progression to HELLP, such as those already presenting with pre-eclampsia instead of gestational hypertension, were shown to benefit from earlier delivery. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

Indexed as

Watchful WaitingAdultCesarean SectionEclampsiaFemaleGestational AgeHELLP SyndromeHumansInfant, NewbornPre-EclampsiaPregnancyPregnancy OutcomePremature BirthRandomized Controlled Trials as TopicRespiratory Distress Syndrome, NewbornRisk Factorsexpectant managementHELLP syndromeimmediate deliverypre-eclampsiaRDS

Identifiers

PMID30697855
PMCPMC6594064
OpenAlexW2914062231

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.