The Cochrane Pregnancy and Childbirth Group has produced more than 600 reviews and one of its first from 1995 looked at the effects of providing support during pregnancy for women at increased risk of having a low birthweight baby. The review underwent another update in April 2019 and we asked a new member of the research team, Christine East from Monash University and La Trobe University in Melbourne, Australia to tell us about the importance of the review and its latest findings.
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Some newborn babies are smaller than expected and this can be for a number of reasons. Sometimes they are simply born early. Others may be born at full term but may not have grown well enough in the womb. Whatever the reason, low birthweight babies face more challenges than babies born at a normal weight.
One of the ideas for how to prevent babies being born small is to provide social support to women during their pregnancy. This might be in the form of emotional support, helping women get to appointments, or helping them understand when to let their midwife or doctor know about any concerns they are having.
Our review examines the evidence on these and other such strategies. We looked at the randomised trials that had tested the effects of programmes offering additional social support to women who were at risk of having a low birthweight baby. Some trials involved support from healthcare professionals, while, in others, lay persons provided the support. The main outcomes were babies born preterm, that is, three or more weeks earlier than the usual 40 weeks, or weighing less than 2500 grams at birth.
We included 25 reports, which had data for more than 11,000 mothers and their babies, across 21 different studies. We found that when compared with routine care, programmes that offered additional social support for these at-risk women may slightly reduce the number of babies born weighing under 2500 grams. There was also evidence that social support might decrease the number of babies born preterm, although the potential effect was not large. We also found that additional social support might reduce the number of births by caesarean section and the number of hospital admissions during pregnancy. And the results were consistent whether the support came from healthcare professionals or specially trained lay persons.
In summary, pregnant women need the support of caring family members, friends and health professionals. Programmes that offer additional social support during pregnancy are unlikely to have a large impact on babies being born small or before term. However, these support services may help in reducing the likelihood of caesarean birth and the need for the woman to have to stay in hospital at some point during her pregnancy.
