Reported outcomes for planned caesarean section versus planned vaginal birth in women aged 18-45: a systematic review

Background There is currently no consensus regarding the outcomes and outcome measures that should be reported in studies assessing planned mode of birth. Objectives To develop an inventory for reported outcomes for studies comparing planned caesarean section (CS) and planned vaginal delivery (VD) for women age 18-45. Search strategy Three online databases, Ovid SP version of MEDLINE and EMBASE and the Cochrane Pregnancy and Childbirth Group’s Trials Register, were searched from 2011 to June 2019. Selection criteria The inclusion criteria were: prospective studies evaluating planned mode of birth, age 18-45, singleton pregnancy, gestational age 37-40 weeks, >100 participants, middle or high income countries. No language restrictions were applied. Data collection and analysis Two researchers independently screened titles and abstracts, and subsequently reviewed the full text of each selected study to assess for eligibility. Discrepancies were resolved by discussion with a third author. The selected studies were evaluated using the MOMENT criteria. Outcomes and outcome measures were systematically extracted and organised into an inventory. Main results 63 prospective studies including data from 6,397,310 women were included. Based on the MOMENT score of 4 or more, 37 studies (59%) were of high quality. In total, 43 different primary outcomes and 79 different primary outcome measures were identified; 12 different secondary outcomes and 31 secondary outcome measures were identified. The primary outcome measurements and definitions of outcomes were inconsistent. Conclusions Prospective studies evaluating outcomes of planned mode of birth frequently report different primary outcomes and outcome measures. Funding: None required