Complementary medicines and therapies in clinical guidelines on pregnancy care: A systematic review |
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| Institution: | 1. NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia;2. School of Medicine, The University of Notre Dame Australia, Broadway, NSW, Australia;3. School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia;4. Obstetrics and Gynaecology Department, Canberra Hospital, Canberra, ACT, Australia;5. Royal Australian and New Zealand College of Obstetricians and Gynaecologists, East Melbourne, VIC, Australia;6. Next Practice Health, Erina, Sydney, NSW, Australia;7. Maternity Service, Wollongong Hospital, Wollongong, NSW, Australia;1. JBI, School of Public Health, Faculty of Health and Medical Science, University of Adelaide, Australia;2. Curtin Medical School, Curtin University, Bentley, WA, Australia;3. Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia;4. Ngangk Yira Research Centre for Aboriginal Health & Social Equity, Murdoch University, Murdoch, WA, Australia;5. Still Aware, South Australia, Australia;6. UniSA Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia;1. School of Nursing and Midwifery, Faculty of Nursing, Suratthani Rajabhat University, 272 Moo 9 Surat-Nasan Road, Muang, Surat Thani 84100, Thailand;2. School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751, NSW, Australia;3. College of Health Sciences, VinUniversity, Hanoi, Vietnam;1. Murdoch University, Australia;2. Victoria University, Australia;3. Ngangk Yira: Research Centre for Aboriginal Health and Social Equity, Murdoch University, Australia;1. Auckland University of Technology, AUT Department of Management, Private Bag 92006, Victoria Street West, Auckland 1142, New Zealand;2. Ludwig-Maximilians-Universität München, Faculty of Psychology, Raum 3432, Leopoldstr. 13, 80802 München, Germany;3. Auckland University of Technology, AUT Midwifery Department, Private Bag 92006, 640 Great South Road, Manukau, Auckland 2104, New Zealand;4. New Zealand College of Midwives, PO Box 21-106, Edgeware, Christchurch 8143, New Zealand |
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| Abstract: | BackgroundThere is a need for evidence-based guidance on complementary medicines and therapies (CMT) use during pregnancy due to high prevalence of use and lack of guidance on the balance of benefit and harms.AimEvaluate the extent to which current clinical practice guidelines relevant to Australian healthcare professionals make clear and unambiguous recommendations about CMT use in pregnancy, and synthesise these recommendations.MethodsThe search included EMBASE, PubMed, the National Health and Medical Research Council’s Clinical Practice Guidelines Portal, and websites of Australian maternity hospitals and professional/not-for-profit organisations for published guidelines on pregnancy care. Data were synthesised narratively. Guidelines were appraised by two independent reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.FindingsA total of 48 guidelines were found, of which 41% provided recommendations that were not limited to routine vitamin and mineral supplementation. There were wide variations in recommendations, particularly for vitamin D and calcium. There was some consensus on recommending ginger and vitamin B6 for nausea and vomiting, and additional supplementation for women with obesity. Guidelines generally scored poorly in the domains of editorial independence and rigour of development.DiscussionThere is a lack of guidance with regard to appropriate CMT use during pregnancy, which may result in less-than-optimal care. Inconsistency between guidelines may lead to variations in care.ConclusionGuidelines should include clear and unambiguous guidance on appropriate CMT use during pregnancy, be based on a structured search of the evidence and informed by stakeholder engagement. |
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| Keywords: | Practice guideline Pregnancy Traditional complementary and integrative medicine Dietary supplements |
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