{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:18:36Z","timestamp":1789172316609,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post\u2010partum haemorrhage (PPH) is a common complication of labour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the effectiveness of oxytocin in comparison to no treatment for preventing PPH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>Published and unpublished randomised controlled trials (RCTs) comparing systemic oxytocin to placebo or no intervention for preventing PPH were included. We did not apply language restrictions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>\n                      We identified RCTs from the Cochrane network meta\u2010analysis on uterotonics for preventing PPH and updated the search via: Ovid MEDLINE, Embase via Ovid, Web of Science, CENTRAL, CINAHL Plus and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>An Individual participant data (IPD) meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>\n                      Of 14 eligible RCTs, four provided IPD (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094304; 51.7% received oxytocin and 48.4% received placebo or no intervention). Meta\u2010analysis of IPD showed that oxytocin decreased the risk of PPH \u2265\u2009500\u2009mL (aOR 0.59; 95% CI 0.46 to 0.74) and PPH \u2265\u20091000\u2009mL (aOR 0.51; 95% CI 0.32 to 0.80). Of 10 RCTs that did not share data, seven met trustworthiness criteria while three did not. Trustworthy IPD and aggregate data (AD) from RCTs meeting trustworthiness criteria (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096003) showed that oxytocin significantly reduced the rate of PPH \u2265\u2009500\u2009mL (aOR 0.53; 95% CI 0.45 to 0.62) and PPH \u2265\u20091000\u2009mL (aOR 0.59; 95% CI 0.48 to 0.71). RCTs not meeting trustworthiness criteria reported a larger risk reduction of oxytocin for PPH \u2265\u2009500\u2009mL (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091027; aOR 0.37; 95% CI 0.03 to 4.03) and PPH \u2265\u20091000\u2009mL (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091157; aOR 0.13; 95% CI 0.01 to 1.45).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prophylactic oxytocin reduces the risk of PPH \u2265\u2009500\u2009mL and PPH \u2265\u20091000\u2009mL compared to no treatment. Twenty\u2010one percent of RCTs did not meet our pre\u2010defined trustworthiness criteria, underlining the importance of integrity assessment in evidence synthesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.18279","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T03:35:59Z","timestamp":1752723359000},"page":"24-33","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effectiveness of Oxytocin for Preventing Postpartum Haemorrhage: An Individual Participant Data Meta\u2010Analysis"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8371-3126","authenticated-orcid":false,"given":"Madeline","family":"Flanagan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsheeya","family":"Rattan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling Shan","family":"Au","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malitha","family":"Patabendige","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole\u2010Anne","family":"Whigham","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suze","family":"Jans","sequence":"additional","affiliation":[{"name":"Department of Child Health TNO  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patience","family":"Cofie","sequence":"additional","affiliation":[{"name":"PATH  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3080-1007","authenticated-orcid":false,"given":"G. Justus","family":"Hofmeyr","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit, University of the Witwatersrand and Walter Sisulu University  East London South Africa"},{"name":"Department of Obstetrics and Gynaecology University of Botswana  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6372-8117","authenticated-orcid":false,"given":"Leiv Arne","family":"Rosseland","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Institute of Clinical Medicine University of Oslo  Oslo Norway"},{"name":"Department of Research and Development, Division of Emergencies and Critical Care Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1909-337X","authenticated-orcid":false,"given":"Andrew","family":"Weeks","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health The University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8980-0909","authenticated-orcid":false,"given":"Wentao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Victoria Australia"},{"name":"National Perinatal Epidemiology and Statistics Unit, Centre for big Data Research in Health and School of Women's and Children's Health The University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"Ben W. 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