Abstract
Background
There 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.
Aim
Evaluate 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.
Methods
The 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.
Findings
A 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.
Discussion
There 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.
Conclusion
Guidelines 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.
Keywords
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Article info
Publication history
Published online: August 18, 2021
Accepted:
August 9,
2021
Received in revised form:
August 5,
2021
Received:
June 14,
2021
Identification
Copyright
© 2021 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
