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A systematic review of clinical guidelines for preconception care

A systematic review of clinical guidelines for preconception care
A systematic review of clinical guidelines for preconception care

Preconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to pregnancy. These interventions seek to enhance conception rates, pregnancy outcomes, childhood health, and the health of future generations. To assist health care providers to exercise high-quality clinical care in this domain, clinical practice guidelines from a range of settings have been published. This systematic review sought to identify existing freely accessible international guidelines, assess these in terms of their quality using the AGREE II tool, and assess the summary recommendations and the evidence level on which they are based. We identified 11 guidelines that focused on PCC. Ten of these were classified as moderate quality (scores ranging from 3.5 to 4.5 out of 7) and only one was classified as very high quality, scoring 6.5. The levels of evidence for recommendations ranged from the lowest possible level of evidence (III) to the highest (I-a): the highest quality evidence available is for folic acid supplementation to reduce risk of neural tube defects and the role of antiviral medication to prevent HIV transmission. This systematic review identified that high-quality guidelines on PCC are lacking and that few domains of PCC recommendations are supported by high-quality evidence.

clinical practice guideline, policy, pre-pregnancy, preconception, systematic review
Dorney, Edwina
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Boyle, Jacqueline
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Walker, Ruth
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Hammarberg, Karin
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Musgrave, Loretta
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Schoenaker, Danielle
84b96b87-4070-45a5-9777-5a1e4e45e818
Jack, Brian
36bf3b91-c3ac-4d73-b2ed-94a2add47f5b
Black, Kirsten
38257da2-aed2-4ec3-9383-b172903fb91a
Dorney, Edwina
689ad9ac-e6e2-49a5-b7a6-44090f4876d3
Boyle, Jacqueline
7ea90ea4-670f-452e-a1fb-128223f69a3f
Walker, Ruth
21fd903b-3bcb-4dd5-b614-e335447bbd74
Hammarberg, Karin
8bbf0f61-bc6d-4f67-b5c4-5cf588c7d241
Musgrave, Loretta
7bfd911d-1544-4b01-8773-0672a5b37fa0
Schoenaker, Danielle
84b96b87-4070-45a5-9777-5a1e4e45e818
Jack, Brian
36bf3b91-c3ac-4d73-b2ed-94a2add47f5b
Black, Kirsten
38257da2-aed2-4ec3-9383-b172903fb91a

Dorney, Edwina, Boyle, Jacqueline, Walker, Ruth, Hammarberg, Karin, Musgrave, Loretta, Schoenaker, Danielle, Jack, Brian and Black, Kirsten (2022) A systematic review of clinical guidelines for preconception care. Seminars in Reproductive Medicine. (doi:10.1055/s-0042-1748190).

Record type: Review

Abstract

Preconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to pregnancy. These interventions seek to enhance conception rates, pregnancy outcomes, childhood health, and the health of future generations. To assist health care providers to exercise high-quality clinical care in this domain, clinical practice guidelines from a range of settings have been published. This systematic review sought to identify existing freely accessible international guidelines, assess these in terms of their quality using the AGREE II tool, and assess the summary recommendations and the evidence level on which they are based. We identified 11 guidelines that focused on PCC. Ten of these were classified as moderate quality (scores ranging from 3.5 to 4.5 out of 7) and only one was classified as very high quality, scoring 6.5. The levels of evidence for recommendations ranged from the lowest possible level of evidence (III) to the highest (I-a): the highest quality evidence available is for folic acid supplementation to reduce risk of neural tube defects and the role of antiviral medication to prevent HIV transmission. This systematic review identified that high-quality guidelines on PCC are lacking and that few domains of PCC recommendations are supported by high-quality evidence.

Text
SRM_SR_for_international_PCC_Guidelines_FINAL (1) - Accepted Manuscript
Restricted to Repository staff only until 16 May 2023.
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Text
Accepted manuscript
Restricted to Repository staff only
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More information

e-pub ahead of print date: 16 May 2022
Published date: 16 May 2022
Keywords: clinical practice guideline, policy, pre-pregnancy, preconception, systematic review

Identifiers

Local EPrints ID: 457517
URI: http://eprints.soton.ac.uk/id/eprint/457517
PURE UUID: 40c270d6-3fc3-496c-84d8-7c4a8fa078ea
ORCID for Danielle Schoenaker: ORCID iD orcid.org/0000-0002-7652-990X

Catalogue record

Date deposited: 09 Jun 2022 17:35
Last modified: 23 Jul 2022 02:27

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Contributors

Author: Edwina Dorney
Author: Jacqueline Boyle
Author: Ruth Walker
Author: Karin Hammarberg
Author: Loretta Musgrave
Author: Brian Jack
Author: Kirsten Black

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