Review and appraisal of guidelines for the management of asthma during pregnancy

McLaughlin, K; Foureur, M; Jensen, ME; Murphy, VE

Review and appraisal of guidelines for the management of asthma during pregnancy

McLaughlin, K Foureur, M

Jensen, ME Murphy, VE

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Publication Type:: Journal Article
Citation:: Women and Birth, 2018, 31 (6), pp. e349 - e357
Issue Date:: 2018-12-01

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Field	Value	Language
dc.contributor.author	McLaughlin, K	en_US
dc.contributor.author	Foureur, M https://orcid.org/0000-0002-0454-0165	en_US
dc.contributor.author	Jensen, ME	en_US
dc.contributor.author	Murphy, VE	en_US
dc.date.available	2018-01-11	en_US
dc.date.issued	2018-12-01	en_US
dc.identifier.citation	Women and Birth, 2018, 31 (6), pp. e349 - e357	en_US
dc.identifier.issn	1871-5192	en_US
dc.identifier.uri	http://hdl.handle.net/10453/129770
dc.description.abstract	© 2018 Australian College of Midwives Background: Asthma affects 12.7% of pregnancies in Australia. Poorly controlled asthma is associated with increased maternal and infant morbidity and mortality. Optimal antenatal management of asthma during pregnancy has the potential to reduce complications relating to asthma. Evidence-based clinical practice guidelines help to translate health research findings into practice and when implemented can improve health outcomes. National and International guidelines currently provide recommendations for optimal asthma care in pregnancy. Aim: To appraise the existing asthma in pregnancy guidelines with respect to their evidence for recommendations, consistency of recommendations and appropriateness for clinical practice. Method: The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to appraise four English language asthma in pregnancy guidelines, published or updated between 2007 and 2016. The recommendations, range and level of evidence was analysed. Results: Two of the four guidelines scored highly in most domains of the appraisal. Many of the recommendations made in the appraised guidelines were consistent. Due to the lack of randomised controlled trials involving pregnant women with asthma, most recommendations were evidenced by consensus and expert opinion rather than high quality meta-analysis, systematic reviews of randomised controlled trials. Conclusion: The recommended antenatal asthma management was generally consistent among the guidelines but lacked clarity in some areas which then leave them open to interpretation. More randomised controlled trials involving pregnant women with asthma are required to fortify the recommendations made and asthma management guidelines should be included in Australian Antenatal Care Guidelines as they currently are not.	en_US
dc.relation.ispartof	Women and Birth	en_US
dc.relation.isbasedon	10.1016/j.wombi.2018.01.008	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Asthma	en_US
dc.subject.mesh	Pregnancy Complications	en_US
dc.subject.mesh	Prenatal Care	en_US
dc.subject.mesh	Evidence-Based Medicine	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Disease Management	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Practice Guidelines as Topic	en_US
dc.title	Review and appraisal of guidelines for the management of asthma during pregnancy	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	31	en_US
utslib.for	1110 Nursing	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	31	en_US

Abstract:

© 2018 Australian College of Midwives Background: Asthma affects 12.7% of pregnancies in Australia. Poorly controlled asthma is associated with increased maternal and infant morbidity and mortality. Optimal antenatal management of asthma during pregnancy has the potential to reduce complications relating to asthma. Evidence-based clinical practice guidelines help to translate health research findings into practice and when implemented can improve health outcomes. National and International guidelines currently provide recommendations for optimal asthma care in pregnancy. Aim: To appraise the existing asthma in pregnancy guidelines with respect to their evidence for recommendations, consistency of recommendations and appropriateness for clinical practice. Method: The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to appraise four English language asthma in pregnancy guidelines, published or updated between 2007 and 2016. The recommendations, range and level of evidence was analysed. Results: Two of the four guidelines scored highly in most domains of the appraisal. Many of the recommendations made in the appraised guidelines were consistent. Due to the lack of randomised controlled trials involving pregnant women with asthma, most recommendations were evidenced by consensus and expert opinion rather than high quality meta-analysis, systematic reviews of randomised controlled trials. Conclusion: The recommended antenatal asthma management was generally consistent among the guidelines but lacked clarity in some areas which then leave them open to interpretation. More randomised controlled trials involving pregnant women with asthma are required to fortify the recommendations made and asthma management guidelines should be included in Australian Antenatal Care Guidelines as they currently are not.

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http://hdl.handle.net/10453/129770