Skip to main content

Table 1 Published randomized controlled trials with moderate- to high-certainty evidence

From: Implementation and evaluation of nonclinical interventions for appropriate use of cesarean section in low- and middle-income countries: protocol for a multisite hybrid effectiveness-implementation type III trial

Study Study design Type of intervention Overall CS rate in % Relative effect (95% CI)
Intervention Control
Baseline Post Baseline Post
Lomas [12] Cluster RCT Opinion leader education   53.7*   66.8* Not reported
  Audit and feedback 69.7* 66.8*
Althabe [13] Cluster RCT Mandatory second opinion 26.3 24.7 24.6 24.9 ARR −1.9 (−3.8 to −0.1)
Chaillet [14] Cluster RCT Audit and feedback 22.5 21.8 23.2 23.5 ARR −1.8 (−3.8 to −0.2)
RCT 8.5** 7.6** 8.5** 9.0** ARR −1.7 (−3.0 to −0.3)
Mansoumi [15] RCT Antenatal education program for physiologic childbirth   45.0   43.7 RR 1.03 (0.72 to 1.49)
Bergstrom [16] RCT Antenatal education on natural childbirth preparation with training in breathing and relaxation techniques   59.9*   63.0* RR 0.95 (0.58 to 1.56)
Fraser [17] RCT Individualized prenatal education and support program versus written information in pamphlet   21.3   23.7 RR 0.90 (0.74 to 1.11)
Montgomery [18] RCT Computer-based decision aids (information program, decision analysis)   48.6*   49.6* RR 0.98 (0.82 to 1.18)
Shorten [19] RCT Decision aid booklet during antenatal care   49.4*   52.2* Not reported
Bohren [11] Meta-analysis Companionship during labor   12.3   15.0 RR 0.75 (0.64 to 0.88)
  1. RCT randomized controlled trial with intervention at the woman’s level; cluster-RCT randomized controlled trial with intervention at the hospital or healthcare provider level
  2. For RCTs, risk ratio (RR) = (mean rate intervention/mean rate control) with 95% confidence intervals
  3. For the meta-analysis of RCTs, the relative effect is the summary risk ratio with 95% confidence intervals
  4. For cluster-RCTs, absolute risk reduction (ARR) = (rate change in the intervention group)—(rate change in the control group) with 95% confidence intervals
  5. *The selected outcome is the elective repeat cesarean section rate among high-risk women (women with previous CS)
  6. **The selected outcome is the overall CS rate among low-risk women (single pregnancy with cephalic presentation without any complication)