Table H.5.5GRADE findings for comparison of planned CS vs. vaginal birth (maternal outcomes)

Quality assessmentSummary of findings
ResultsEffect
No. of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsMaternal request CSPlanned vaginal birthComparative

t test/chi2

(p value)
AbsoluteQuality
Maternal hospital stay (mean days)
1 study

(Wiklund et al., 2007)
observational studyserious1,2no serious inconsistencyno serious indirectnessno serious imprecisionnone3.62.834.40

(0.001)
0.8 days moreVery low
Birth experience (at 2 days postpartum) (mean Likert scale score where1 = worst, 10 = best)
1 study

(Wiklund et al., 2007)
observational studyserious1,2no serious inconsistencyno serious indirectnessno serious imprecisionnone8.36.731.25

(0.001)
1.6 moreVery low
Birth experience (at 3months postpartum) (mean Likert scale score where1 = worst, 10 = best)
1 study

(Wiklund et al., 2007)
observational studyserious1,2no serious inconsistencyno serious indirectnessno serious imprecisionnone8.16.614.66

(0.002)
1.5 moreVery low
Uncomplicated breastfeeding (at 2 days postpartum)
1 study

(Wiklund et al., 2007)
observational studyserious1,5no serious inconsistencyno serious indirectnessserious3none50/92

(54%)
162/237

(68%)
10.95

(0.052)
1.4/1000 fewerVery low
Breastfeeding (at 3 months postpartum)
1 study

(Wiklund et al., 2007)
observational studyserious1,4no serious inconsistencyno serious indirectnessno serious imprecisionnone79%*248/266

(93%)
22.65

(0.001)
1.4/1000 fewerVery low
Coitus (at 3 months postpartum)
1 study

(Wiklund et al., 2007)
observational studyserious1,4no serious inconsistencyno serious indirectnessserious3none57%*67%*2.61

(0.106)
1.0/1000 fewerVery low
Family planning (plans for a sibling at 3 months postpartum)
1 study

(Wiklund et al., 2007)
observational studyserious1,4no serious inconsistencyno serious indirectnessno serious imprecisionnone52%*81%*28.13

(0.001)
2.9/1000 fewerVery low
Depression (Edinburgh Postnatal Depression Scale)
1 study

(Wiklund et al., 2007)
observational studyserious1,4no serious inconsistencyno serious indirectnessserious3nonenot reported (NR)NRp = 0.877not calculableVery low
1

Groups differ significantly at baseline for age, native Swede, IVF, planned pregnancy, parenthood education and perceived good health. Inconsistent and poor reporting of results

2

SD of mean not provided

3

Not statistically significant

4

Total number in case and/or control group not provided

5

Vaginal birth includes 11% emergency CS, results for the number of women who gave birth vaginally not reported separately

*

Total number in case and/or control group not provided. Percentage figures are those reported in the study

From: Appendix H, GRADE tables

Cover of Caesarean Section
Caesarean Section.
NICE Clinical Guidelines, No. 132.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2011 Nov.
Copyright © 2011, National Collaborating Centre for Women's and Children's Health.

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