Reported outcomes for planned caesarean section versus planned vaginal delivery: 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.

OBJECTIVE: To develop an inventory for reported outcomes for studies comparing planned caesarean section (CS) and planned vaginal delivery (VD) for women age 18-45.

METHODS: A systematic review of outcomes reported in prospective studies investigating planned CS and planned VD was conducted. 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. 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. 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.

RESULTS: 63 prospective studies comparing planned CS versus planned VD including data from 6,397,310 women were included. 37 studies (59%) investigating planned CS versus planned VD fulfilled four or more MOMENT criteria. In total, 43 different primary outcomes and 79 different primary outcome measures, and 12 different secondary outcomes and 31 secondary outcome measures were identified from studies investigating planned CS versus planned VD.

CONCLUSION: The findings of this study will contribute to the development of a core outcome set for planned mode of birth in the future. Standardising outcomes will aid comparison and interpretation of data pertaining to planned CS versus planned VD.