Evidence for Maternity Care: new evidence and resources – Quarter 1 2021

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.

COVID-19

Cochrane is producing reviews and resources for the COVID-19 pandemic. We have blogged about many of them and this blog COVID-19 evidence: a Cochrane 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.

Cochrane’s response to the pandemic had to meet the needs of evidence users and decision‐makers as it developed and how this is being done is discussed in an Editorial COVID-19: working together and making a difference for decision-makers.

Drawing on a Cochrane Review on supporting resilience and mental well-being in frontline healthcare professionals during and after a pandemic (November 2020) there is now a brief for health systems planners and implementers. You might also be interested in the Special Collection Coronavirus (COVID-19): support for wellbeing in the healthcare workforce.

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 Podcasts

Cochrane COVID-19 Podcasts offer short summaries of Cochrane COVID-19 reviews from the authors themselves. A good way to hear the latest Cochrane evidence in under 5 minutes each.

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

Antenatal steroids for reducing risk of infant mortality and morbidity

Featured Review: Antenatal corticosteroids for accelerating fetal lung maturation in women at risk of preterm birth 

“When I unexpectedly went into premature labour with our second son at a little under 32 weeks’ gestation, I was given steroid injections to give his lungs the best possible chance…”  Read Rebecca Selby’s story of how Cochrane evidence impacted her family in Wearing Cochrane evidence: a personal story of impact.

Communication 

Cochrane Clinical Answer: For pregnant and postpartum women, does targeted client communication improve maternal and neonatal health?

Gestational diabetes

Cochrane Clinical Answer: For pregnant women with gestational diabetes, how do probiotics compare with placebo for improving maternal and infant health and well‐being? 

Intrahepatic cholestasis

Cochrane Clinical Answer: What are the effects of ursodeoxycholic acid (UDCA) for treating intrahepatic cholestasis of pregnancy? 

Preventing incontinence

Cochrane Podcast: How effective is pelvic floor muscle training undertaken during pregnancy or after birth for preventing or treating incontinence?

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

Preventing pregnancy loss and stillbirth

Cochrane Clinical Answer: For women with persistent antiphospholipid antibodies and recurrent pregnancy loss, how does heparin plus aspirin compare with aspirin alone? 

An overview of 43 Cochrane Reviews assessing 61 different strategies for preventing stillbirth during pregnancy, or infant deaths around the time of birth is summarised in What are the most effective interventions during pregnancy for preventing stillbirth?  We hope to have an Evidently Cochrane blog on this overview in the coming months.

Meanwhile, don’t miss the blog Pregnancy after stillbirth: experience and evidence gaps in which Susannah Leisher writes 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. The blog also highlights an ongoing opportunity to become a stillbirth spokesperson

Postnatal care and care of the newborn

Continuous glucose monitoring

Cochrane Review: Continuous glucose monitoring for the prevention of morbidity and mortality in preterm infants (December 2020) 

Diet fortification for preterm infants

Cochrane Review: Individualized versus standard diet fortification for growth and development in preterm infants receiving human milk (November 2020) 

Early full enteral feeding for preterm/low birth weight infants

Cochrane Review: Early full enteral feeding for  preterm or low birth weight infants (December 2020)

Mastitis

Cochrane Clinical Answer: Do probiotics and massage help prevent mastitis after childbirth?

Neonatal jaundice

Neonatal jaundice: Cochrane evidence on prevention and treatment  is a blog for health professionals, written by Paediatric Registrar Katie Westwood, looking at relevant Cochrane evidence from multiple reviews.

Fluid supplementation may shorten the duration of phototherapy. Using reflective materials with standard phototherapy probably reduces hospital stay. Prebiotics may be of benefit in preventing neonatal jaundice. This evidence is from small studies and more research is required before recommendations can be made for clinical practice.

Opioid withdrawal in newborns

Cochrane Review: Non-pharmacological care for opioid withdrawal in newborns (December 2020)

Patent ductus arteriosus

Cochrane Review: Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infant (December 2020)

Perineal pain

The Evidently Cochrane blog Perineal pain after birth: what can help? draws on the blogger Jennifer Hanratty’s personal experience as she looks at the Cochrane evidence. The blog has been updated with the latest evidence in January 2021. 

Cochrane Clinical Answer: For women with perineal trauma sustained during childbirth, does an ice pack or cold gel pad alleviate pain? 

Probiotics for preventing necrotizing enterocolitis

Cochrane Clinical Answer: For very preterm or very low birth weight infants, what are the effects of probiotics for preventing necrotizing enterocolitis?

Skin-to-skin contact

“In June 2020, the WHO stated that skin-to-skin contact and breastfeeding should still be encouraged for new mothers and their babies in cases of suspected or confirmed COVID-19. Early evidence suggests that the benefits of skin-to-skin and breastfeeding far outweigh any risks.” Read more about how a Cochrane Review has informed 20 sets of guidelines around the world.

Uterine cramping

For this Cochrane Review Relief of pain due to uterine cramping/involution after birth (October 2020), there is a short video summary below.

Emergency care

Emergency Care

Featured Review: Helping families secure a step‐up to emergency care for patients with a life-threatening condition 

Healthcare worker education and training

Impact of printed educational materials

Cochrane Clinical Answer: Does RCT evidence show that printed educational materials for healthcare professionals alter healthcare professionals’ practice and/or patient outcomes?

Infection control

Cochrane Clinical Answers: Does healthcare worker education improve adherence to standard precautions for controlling health care‐associated infections?

Simulation-based team training in obstetric emergencies

Cochrane Review: Multi‐professional simulation‐based team training in obstetric emergencies for improving patient outcomes and trainees’ performance.

Workplace aggression

Cochrane Clinical Answer: Does RCT evidence show that education and training of healthcare workers help prevent or minimize workplace aggression directed toward them? 

Healthcare worker health and wellbeing

Cochrane Clinical Answer: Do psychological interventions help foster resilience among healthcare students? 

Cancer

We recognise that those working in maternity care may occasionally care for women who have cancer, or are supporting a close family member with cancer. Contemplating Cancer – a special series is a thought-provoking series of Evidently Cochrane blogs in which people share personal and professional experience of cancer, along with Cochrane evidence and artwork.

Coming up…

On 20-22 April 2021 we are holding an online event ‘Virtually Cochrane’ for all those involved with, or interested in, planning, doing, sharing and using research evidence. Registration will open in February.

The next collection of evidence will be published here in April 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, and @CochraneNeonate 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)

Sarah Chapman and Selena Ryan-Vig have nothing to disclose.



Evidence for Maternity Care: new evidence and resources – Quarter 1 2021 by Sarah Chapman

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

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