A Cochrane review [Abstract] 1 included four small trials with a total of 449 subjects. Three of the trials were of good quality. Two trials (145 women) compared strict bed rest with some rest, in hospital, for women with proteinuric hypertension demonstrating no differences for reported outcomes. Two trials (304 women) compared some bed rest in hospital with routine activity at home for non-proteinuric hypertension. There was reduced risk of severe hypertension (1 trial, 218 women; RR 0.58, 95% CI 0.38 to 0.89) and a borderline reduction in risk of preterm birth (1 trial, 218 women; RR 0.53, CI 0.29 to 0.99) with some rest compared to normal activity. More women in the bed rest group opted not to have the same management in future pregnancies, if the choice were given (1 trial, 86 women; RR 3.00, 95% CI 1.43 to 6.31). There were no significant differences for any other outcomes.
Comment: The quality of evidence was downgraded by imprecise data due to limited study sizes, and by some uncertainty of directness.
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