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Current resources for evidence-based practice, january/february 2009

Current Resources for Evidence-Based Practice,January/February 2009 Published simultaneously in Journal of Obstetric, Gynecologic & able without charge from Childbirth Connection’s website). (Disclosure: thisauthor is an employee of Childbirth Connection).
MILBANK REPORT PROPOSES FRAMEWORK FOR EVIDENCE-BASED MATERNITY CARE AND POLICY RECOMMENDATIONSFOR IMPROVEMENT A new Milbank Report focuses on the potential to greatly 1. Sakala C, Corry MP. Evidence-Based Maternity Care: What It Is and What It Can Achieve. New York, Milbank Memorial Fund, improve maternity care in the United States through greater 2008. 115 p. Available without charge from: fidelity to evidence-based practice.1 The report, authored by Carol Sakala and Maureen Corry, was developed col-laboratively by Childbirth Connection and the MilbankMemorial Fund along with members of the Reforming FROM COCHRANE DATABASE OF SYSTEMATIC REVIEWS (CDSR), States Group. Childbirth Connection is a national, not- for-profit organization dedicated to improving the quality of maternity care through research, education, policy, andadvocacy. The Reforming States Group is a voluntary co-  Amniotic fluid index versus single deepest pocket as alition of government experts in health policy from all 50 a screening test for preventing adverse pregnancy outcome states, with additional members from Australia, Canada,  Antenatal breast examination for promoting breastfeed- Scotland, and the UK. The Milbank Memorial Fund, founded in 1905, is a national foundation that provides  Hysterectomy versus hysterectomy plus oophorectomy nonpartisan analysis of health policy issues to inform and support the work of private and public health policymakers.
 Interventions for ketosis during labour The report, entitled Evidence-Based Maternity Care:  Methods of delivering the placenta at caesarean section What It Is and What It Can Achieve, takes stock of the per-  Ovulation triggers in anovulatory women undergoing formance of the current maternity care system by considering care processes, maternal and newborn outcomes and value  Preconception counseling for women with epilepsy to for purchasers. It proposes a framework for evidence-based maternity care based on the principles of ‘‘effective care  Psychosocial interventions for women enrolled in alco- with least harm’’ to mothers and babies, and reliance on best quality evidence. The proposed framework is applied  Rapid versus stepwise negative pressure application for in an analysis of current maternity care practices in the United States, identifying gaps between evidence and prac- tice. Practices that are overused, under-used, or commonly  Surgical techniques for uterine incision and uterine used despite uncertainty about their effects are called out, and the relationship between evidence about biological  Uterine massage for preventing postpartum haemor- childbearing processes and maternity care interventions is discussed. Many systematic reviews that could be used toimprove maternity care for large proportions of mothers and babies by limiting overused practices to appropriate cir-cumstances and rectifying underuse of beneficial practices  Antibiotic duration for treating uncomplicated, symp- are reviewed. Finally, barriers to wider adoption of evi- tomatic lower urinary tract infections in elderly women dence-based maternity care are identified, and policy recom-  Bladder neck needle suspension for urinary inconti- mendations for greater uptake of evidence are proposed.
Electronic copies of Milbank Reports are available  Erythromycin for the prevention and treatment of feed- Journal of Midwifery & Women’s Health  1526-9523/09/$36.00  doi:10.1016/j.jmwh.2008.10.014  Extracorporeal membrane oxygenation for severe respi- 1 diabetes mellitus. In their analysis, the authors identified and adjusted for potential confounders using regression  Methylxanthine treatment for apnea in preterm infants techniques on each individual study, and then performed  Neonatal screening for sickle cell disease meta-analysis on adjusted estimates or individual patient  Psychological interventions for women with metastatic data. The study demonstrated a 20% increase in type 1 di- abetes associated with cesarean delivery after controlling  Regular self-examination or clinical examination for for gestational age, birth weight, birth order, breastfeed- ing, maternal age and maternal diabetes.
 Servo-control for maintaining abdominal skin tempera- Comment: This study reports a significant increase in the risk for childhood onset type 1 diabetes associated  Surgery versus primary endocrine therapy for operable with cesarean delivery. Of interest, two other reviews pub- primary breast cancer in elderly women (70 years plus) lished in the journal Clinical and Experimental Allergy in  Vitamin A supplementation for reducing the risk of the same time period and included in the current column mother-to-child transmission of HIV infection demonstrate an increased risk of similar magnitudebetween cesarean delivery and childhood asthma, and Cochrane Reviews are available by subscription to The between cesarean delivery and food allergy, allergic rhini- Cochrane Library, and review abstracts are available tis, asthma and hospitalization for asthma. In those reviews, it was not possible to control for potential con-founders. Meta-analysis provides clarification of the mag- FROM DATABASE OF ABSTRACTS OF REVIEWS OF EFFECTS nitude of observed associations but does not allow inferences about causation. Taken together, the evidence Recent Abstract Entries Assessing Quality of Systematic from these reviews strongly suggests a relationship be- tween cesarean delivery and subsequent alteration inchildhood immune function for which the exact mecha-  Dietary supplements and herbal remedies for premen- strual syndrome (PMS): A systematic research reviewof the evidence for their efficacy Featured review: Himpens E, Van den Broeck C, Oostra  Disease-modifying antirheumatic drugs in pregnancy: A, Calders P, Vanhaesebrouck P. Prevalence, type, distri- Current status and implications for the future bution, and severity of cerebral palsy in relation to gesta-  Effect of sulfadoxine-pyrimethamine resistance on the tional age: A meta-analytic review. Dev Med Child Neuro efficacy of intermittent preventive therapy for malaria control during pregnancy: A systematic review The authors conducted a meta-analysis of 25 epidemiolog-  Effectiveness and safety of ritodrine hydrochloride for ical studies published after 1985 to clarify the relationship the treatment of preterm labour: A systematic review between gestational age and prevalence rates and charac-  Examining differential treatment effects for depression teristics of cerebral palsy (CP) in liveborn, surviving in- in racial and ethnic minority women: A qualitative sys- fants. The study confirmed a significant dose-responsive decrease in the prevalence of CP with increasing gesta-  Long-term risk of invasive cervical cancer after treat- tional age, clarifying that this decline is first observed at ment of squamous cervical intraepithelial neoplasia 27 weeks’ gestation. The rates of CP by gestational age  Progesterone for the prevention of preterm birth: A were as follows: 14.6% at 22 to 27 weeks, 6.2% at 28 to 31 weeks, 0.7% at 32 to 36 weeks, and 0.1% at term.
 SSRIs during breastfeeding: Spotlight on milk-to-plasma The spastic form of CP dominated in preterm infants whereas non-spastic CP was more common in term in- DARE abstracts are available without charge at fants. Due to a lack of standard nomenclature to define the severity of CP, it was not possible to make inferencesabout acuity in relation to gestational age.
Comment: Technological advances in perinatal care in EVIDENCE-BASED REVIEWS FROM OTHER SOURCES recent decades have led to increased survival of infants Featured review: Cardwell CR, Stene LC, Joner G, Cinek born at earlier gestational ages. This study clarifies current O, Svensson J, Goldacre MJ, et al. Caesarean section is prevalence rates of CP, providing new information about associated with an increased risk of childhood-onset the association between the rate and types of CP and ges- type 1 diabetes mellitus: A meta-analysis of observational studies. Diabetologia 2008;51(5):726–35.
Featured review: Beining RM, Dennis LK, Smith EM, Dokras A rigorously conducted meta-analysis explored the associ- A. Meta-analysis of intrauterine device use and risk of endo- ation between cesarean delivery and childhood onset type metrial cancer. Ann Epidemiol 2008;18(6):492–9.
A meta-analysis of 10 analytic studies reporting the effect  Hannula L, Kaunonen M, Tarkka MT. A systematic re- of intrauterine device (IUD) use on risk of endometrial view of professional support interventions for breast- cancer was performed. Since cancer diagnosis dates in feeding. J Clin Nurs 2008;17(9):1132–43.
the studies predated marketing of hormonal IUDs, the ef-  Harder T, Plagemann A, Harder A. Birth weight and fects were attributed to inert and copper-containing IUDs subsequent risk of childhood primary brain tumors: only. Some, but not all, included studies controlled for po- A meta-analysis. Am J Epidemiol 2008;168(4):366–73.
tential confounders that could attenuate or magnify the as-  Mol F, Mol BW, Ankum WM, van der Veen F, Haje- sociation between IUD use and endometrial cancer risk.
nius PJ. Current evidence on surgery, systemic metho- Based on the adjusted pooled analysis, women who had trexate and expectant management in the treatment of ever used an IUD were 46% less likely to develop endome- trial cancer than never users. In addition, a linear duration analysis for the effect of each 5-year increment up to 20  Moretti ME, Rezvani M, Koren G. Safety of glyburide years showed a significant decrease in risk associated for gestational diabetes: A meta-analysis of pregnancy with years of IUD use, years since last IUD use (recency), outcomes. Ann Pharmacother 2008;42(4):483–90.
and years since first IUD use (latency).
 Naughton F, Prevost AT, Sutton S. Self-help smoking Comment: Despite potential limitations, this study cessation interventions in pregnancy: A systematic re- strongly suggests that non-hormonal IUDs exert a protec- view and meta-analysis. Addiction 2008;103(4):566–79.
tive effect against endometrial cancer, the mechanism for  Rasmussen SA, Chu SY, Kim SY, Schmid CH, Lau J.
which is not currently understood. Future studies includ- Maternal obesity and risk of neural tube defects: A ing hormonal IUDs are likely to exhibit an even greater meta-analysis. Am J Obstet Gynecol 2008;198(6):611–9.
protective effect because progestins are known to decrease  Shah NR, Jones JB, Aperi J, Shemtov R, Karne A, proliferation of the uterine lining.
Borenstein J. Selective serotonin reuptake inhibitorsfor premenstrual syndrome and premenstrual dys-phoric disorder: A meta-analysis. Obstet Gynecol2008;111(5):1175–82.
 Taylor P, Potts HW. Computer aids and human second  Aagaard H, Hall EO. Mothers’ experiences of having reading as interventions in screening mammography: a preterm infant in the neonatal care unit: A meta-syn- Two systematic reviews to compare effects on cancer thesis. J Pediatr Nurs 2008;23(3):e26–36.
detection and recall rate. Eur J Cancer 2008;44(6):  Akc¸il M, Karaag˘aog˘lu E, Demirhan B. Diagnostic accu- racy of fine-needle aspiration cytology of palpable  Thavagnanam S, Fleming J, Bromley A, Shields MD, breast masses: An SROC curve with fixed and random Cardwell CR. A meta-analysis of the association be- effects linear meta-regression models. Diagn Cytopa- tween caesarean section and childhood asthma. Clin  Bager P, Wohlfahrt J, Westergaard T. Caesarean deliv-  Viswanathan M, Siega-Rix AM, Moos M-K, Deierlein ery and risk of atopy and allergic disease: Meta-analy- A, Mumford S, Knaack J, et al. Outcomes of maternal ses. Clin Exp Allergy 2008;38(4):634–42.
weight gain. Evidence Report/Technology Assessment  Brostrøm S, Lose G. Pelvic floor muscle training in the No.168. (Prepared by RTI International-University of prevention and treatment of urinary incontinence in North Carolina Evidence-based Practice Center under women-What is the evidence? Acta Obstet Gynecol Contract No. 290-02-0016.) AHRQ Publication No.
08-E009. Rockville, MD: AHRQ. May 2008. Available  Canonico M, Plu-Bureau G, Lowe GD, Scarabin PY.
Hormone replacement therapy and risk of venous throm- boembolism in postmenopausal women: Systematic  Zhou B, Yang L, Sun Q, Cong R, Gu H, Tang N, et al.
review and meta-analysis. BMJ 2008;336(7655):1227– Cigarette smoking and the risk of endometrial cancer: A meta-analysis. Am J Med 2008;121(6):501–8.
 Creanga AA, Bradley HM, McCormick C, Witkop CT.
R. Rima Jolivet, CNM, MSN, MPH, is Associate Director of Programs atChildbirth Connection, which works with health professionals and other Use of metformin in polycystic ovary syndrome: A audiences to promote evidence-based maternity care ( meta-analysis. Obstet Gynecol 2008;111(4):959–68.
Journal of Midwifery & Women’s Health 



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