Bed rest in hospital for suspected impaired fetal growth

Too little evidence from trials to show whether hospital bed rest for pregnant women has a beneficial effect on the unborn baby's growth.

An unborn baby receiving too few nutrients can grow more slowly than expected in the womb (impaired fetal growth). Bed rest is sometimes suggested to mothers of these babies with the view that less maternal physical activity could result in more nutrients for the baby. However, bed rest can be disruptive and there are concerns about an increased risk of maternal blood clotting. This review of one study, involving 107 women, found too little evidence to show whether hospital bed rest for pregnant women is beneficial to the unborn baby. More research is needed into the effects on women and their babies.

Authors' conclusions: 

There is not enough evidence to evaluate the use of a bed rest in hospital policy for women with suspected impaired fetal growth.

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Background: 

Bed rest in hospital or at home is widely advised for many complications of pregnancy. The increased clinical supervision needs to be balanced with the risk of thrombosis, the stress on the pregnant women, as well as the costs to families and health services.

Objectives: 

The objective of this review was to assess the effects of bed rest in hospital for women with suspected impaired fetal growth.

Search strategy: 

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (March 2010).

Selection criteria: 

Randomised trials comparing a policy of bed rest in hospital with ambulatory management for women with suspected impaired fetal growth.

Data collection and analysis: 

Trial quality was assessed.

Main results: 

One study involving 107 women was included. Allocation of treatment was by odd or even birth date. There were differences in baseline fetal weights and birthweights, but these were not statistically significant (mean estimated fetal weight deviation at enrolment was -21.7% for the bed rest group and -20.7% for the ambulatory group; mean birthweight was -19.7% for the bed rest group and -20.6% for the ambulatory group). No differences were detected between bed rest and ambulatory management for fetal growth parameters (risk ratio 0.43, 95% confidence interval: 0.15 to 1.27) and neonatal outcomes.

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