Evidence for Maternity Care: new evidence and resources – Autumn 2020

The latest evidence and resources for midwives and clinical support staff. You can either scroll through this page or click on any of the links below to jump to the relevant section.

Please note, unlike the rest of our blogs, our ‘Evidence for Maternity Care: new evidence and resources’ blogs will not be updated.



COVID-19

Cochrane is producing reviews and resources for the COVID-19 pandemic. We have blogged about many of them and this blog Cochrane evidence on COVID-19: a round-up brings together a large collection of evidence and resources, starting from when this evidence was first being produced in spring 2020. Like the reviews themselves, all our blogs are updated to reflect new evidence.

You may be interested in our blog Personal protective equipment (PPE) for healthcare workers: new Cochrane evidence which discusses the evidence from two Cochrane Reviews and some innovative ideas.

Take-home points • An updated review and a new rapid review on PPE have been produced as part of Cochrane’s organizational effort to meet the need for up-to-date summaries of evidence to support decision-making in combating the effects and impact of COVID-19. • These reviews contribute to the evidence base about a range of considerations in PPE use, including barriers and facilitators to healthcare workers adherence to infection prevention and control guidelines. There are some new, creative solutions being developed to address some of the issues associated with wearing PPE.

Could antimicrobial mouthwashes and nasal sprays offer protection to healthcare workers, and also patients? Three Cochrane Reviews looked for evidence on this and were published in September 2020. It is disappointing that no completed studies were found, but there are studies underway and these will be considered for future updates of the reviews.

Cochrane Special Collections

Cochrane Special Collections assemble Cochrane Reviews on important topics for the prevention and treatment of COVID-19. They are developed with experts from our global Cochrane network. They are based on World Health Organization interim guidance, and continuously updated.

You can find Coronavirus (COVID-19) Special Collections here.

Cochrane Clinical Answers

Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically-focused entry point to rigorous research from Cochrane Reviews. They are designed to be actionable and to inform point-of-care decision-making. Each CCA contains a clinical question, a short answer, and data for the outcomes from the Cochrane Review deemed most relevant to practising healthcare professionals. The evidence is displayed in a user-friendly tabulated format that includes narratives, data, and links to graphics.

You can find Cochrane Clinical Answers related to COVID-19 here.



Antenatal care

Non-severe hypertension in pregnancy

The World Health Organization (WHO) has released recommendations on drug treatment for non-severe hypertension in pregnancy. Five Cochrane Reviews have contributed to these. You can read more about this from Cochrane in this item Five Cochrane Pregnancy and Childbirth reviews inform WHO recommendations on drug treatment for non-severe hypertension in pregnancy.

Gestational diabetes

A Cochrane Clinical Answer: Which interventions prevent pregnant women from developing gestational diabetes?

What matters to women in antenatal care?

A Cochrane Clinical Answer: What aspects of antenatal care are important to women, and which organizational factors impact their use of those services?

Preventing urinary incontinence

A Cochrane Clinical Answer: In pregnant women, does antenatal pelvic floor muscle training help to prevent urinary incontinence?



Labour and birth

Induction of labour

Induction of labour: if, and when, to induce is a blog written for pregnant women and those supporting them. Associate Professor Philippa Middleton and co-authors discuss their recently updated Cochrane Review looking at the effects for women and their babies of inducing labour towards the end of pregnancy.

If, and when, to induce labour in late pregnancy is controversial and there is variation in policy and practice. A recent Cochrane Review found evidence that when women are induced in late pregnancy, rather than waiting for birth to happen, there are fewer perinatal deaths, fewer babies requiring a visit to intensive care and probably fewer caesareans required. Women’s values and preferences vary, so there needs to be collaborative discussion and shared decision-making about whether and when induction is the best course of action.

Skin preparation for women undergoing Caesarean section

A Cochrane Clinical Answer: For women undergoing caesarean section, how does chlorhexidine compare with povidone‐iodine for skin preparation?



Current opportunities

Become a Stillbirth Spokesperson

The Stillbirth Advocacy Working Group (SAWG) is a group of bereaved parents, clinicians, researchers, and others who are interested in raising awareness of stillbirth globally so that we can help end preventable stillbirths and ensure appropriate respectful care when these deaths do happen. SAWG is co-chaired by the International Stillbirth Alliance (ISA) and the London School of Hygiene & Tropical Medicine (LSHTM). 
        
SAWG is compiling a list of Stillbirth Spokespersons – individuals with personal experience of stillbirth willing to raise their voices to increase awareness. Stillbirth Spokespersons may be parents, other affected family members, midwives, other clinicians, counselors, or others with personal experience of stillbirth. SAWG will maintain the Stillbirths Spokespersons list as a resource for the media and other public and private organizations such as United Nations agencies who wish to raise awareness of stillbirth through including the voices of those affected.
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If you wish to volunteer to be added to the list of Stillbirth Spokespersons, please fill in this brief survey. Please contact SAWG co-chairs Susannah Leisher shleisher@aol.com or Hannah Blencowe hannah.blencowe@lshtm.ac.uk if you have questions about this survey or are interested in joining SAWG. Thank you!
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Susannah has co-authored a highly impactful Evidently Cochrane blog Pregnancy after stillbirth: experience and evidence gaps, writing of her experiences when her son Wilder was stillborn, and the impact on her subsequent pregnancies. With researcher Aleena Wojcieszec she looks also at gaps in the evidence on how to care for women and their families in pregnancies after stillbirth. Many women have shared their own experiences through comments on the blog. Please read and share with others.
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Coming up…

The first World Evidence Based Healthcare Day will take place on 20 October 2020. This is an initiative launched by Cochrane and six other leaders in the field, to create awareness of the need for better evidence to inform healthcare policy, practice and decision making in order to improve health outcomes globally.

You can find information and resources on the World Evidence Based Healthcare Day website and look out for content on social media #WorldEBHCDay  #EvidencetoImpact.

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The next collection of evidence will be published here in January 2021. We may have new blogs and blogshots on individual reviews meanwhile.  You can find all our blogs relevant to maternity care here and blogshots here.

Join in the conversation on Twitter with @CochraneUK @CochranePCG or leave a comment on the blog. Please note, we will not publish comments that link to commercial sites or appear to endorse commercial products. We welcome diverse views and encourage discussion but ask that comments are respectful and reserve the right to not publish comments we consider offensive.

References (pdf)



Evidence for Maternity Care: new evidence and resources – Autumn 2020 by Sarah Chapman

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

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