Quality and Content Concordance of International Clinical Guidelines on Hypertensive Disorders of Pregnancy Using the AGREE II Instrument: An Updated Systematic Review

被引:0
|
作者
Bazzano, Alessandra N. N. [1 ]
Keenan, Alexandra [2 ]
Woltz, Sara [1 ]
Subramanian, Advaith [3 ]
Akpogheneta, Onome [1 ,4 ]
Coronado Daza, Jorge [5 ]
Bazzano, Lydia A. L. [2 ]
机构
[1] Tulane Univ, Dept Social Behav & Populat Sci, Sch Publ Hlth & Trop Med, New Orleans, LA 70112 USA
[2] Tulane Univ, Dept Epidemiol, Sch Publ Hlth & Trop Med, 1440 Canal St, New Orleans, LA 70112 USA
[3] Tulane Univ, Murphy Inst, Sch Liberal Arts, New Orleans, LA 70118 USA
[4] London Sch Hyg & Trop Med, Infect Dis Program, London WC1E 7HT, England
[5] Univ Cartagena, Dept Med, Cartagena 130014, Colombia
关键词
hypertension; women's health; pregnancy-induced hypertension; vascular diseases; MATERNAL PREECLAMPSIA; RISK; MANAGEMENT; DIAGNOSIS; INFANT; ASSOCIATION; PREVENTION; EPILEPSY; STROKE; TRENDS;
D O I
10.3390/jcdd10070295
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Utilization of high-quality clinical practice guidelines has the potential to positively impact health outcomes. This study aimed to assess the quality and content concordance of national and international recommendations on hypertensive disorders of pregnancy (HDPs). Searches were conducted of the MEDLINE database and reference lists generated from national and international agencies. Covidence software was used for the management of the systematic review process, the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was used to assess guidelines for quality, and three reviewers independently screened records. The research team identified and screened a total of 399 records of which 10 were deemed high quality. Guidelines were assessed and compared regarding the treatment, prevention, and categorization of disorders. The quality of guidelines varied across different domains, with significant variation in domain scores even within individual guidelines. Not all recommendations showed a high level of methodologic rigor, and the highest-rated guidelines were from the American Heart Association, the World Health Organization, and South Africa national guidelines. Classification of hypertension differed among the guidelines, particularly in defining chronic hypertension, severe hypertension, and preeclampsia. Prevention modalities varied across guidelines, with recommendations for aspirin, calcium supplementation, and against the use of certain approaches. Treatment modalities highlighted the importance of delivery as the definitive way to terminate hypertensive disorders of pregnancy, with other management strategies provided for symptom control. The variability in guidelines and consensus statements across different contexts may reflect regional differences in healthcare practices, available resources, and research evidence. There is potential to harmonize guidelines for HDP globally while considering the unique needs of individual countries. Where guidelines may be synthesized and condensed into an accessible format, doing so could improve their use in clinical decision-making.
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页数:13
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