Fourteen RCTs were included in the review with 1,535 participants (784 in the intervention groups and 751 in the control groups).
There was no clear evidence of increased maternal infections. Chorio-amnionitis (5 trials) OR = 0.86, 95% CI: 0.53, 1.38) and endometritis (5 trials) OR = 1.66, 95% CI: 0.97, 2.83).
The evidence for increased perinatal complications were mixed. Neonatal respiratory distress (RDS) (12 trials) OR = 0.59, 95% CI: 0.46, 0.76; necrotising enterocolitis (3 trials) OR = 0.47, 95% CI: 0.12, 1.23; neonatal infection (8 trials) OR = 1.23, 95% CI: 0.71, 2.14; and perinatal death 7 trials) OR = 0.54, 95% CI: 0.30, 0.95.
Two of the trials reported neonatal infection only on the subset of neonates where the membranes were ruptured for longer than 24 hours before delivery (OR = 2.31, 95% CI: 0.77, 6.99).