Current Resources for Evidence-Based Practice, September/October 2006 Carol Sakala
Published simultaneously in Journal of Midwifery and Women’s Health 2006;51(5).
Contraception Guidance From Model Best Evidence Process The World Health Organization (WHO) and U.S. agency and academic partners have established a state-of-the-science system for staying abreast of best contraception evidence. The system is used to update WHO guidance about who can use speciﬁc contraceptive methods safely (World Health Organization, 2004a) and how to safely and effectively use contraceptive methods deemed appropriate (World Health Organization, 2004b). The WHO and many countries rely on this guidance for policies and programming. In 2002, WHO and its partners established a system to identify and assess potentially relevant evidence for contraceptive eligibility/use as it becomes available and to use relevant better quality evidence to develop new systematic reviews or update existing reviews. This Continuous Identiﬁcation of Research Evidence program maintains a database that is searchable by method, condition, and practice (available from: http://www.infoforhealth.org/cire/). Over 40 systematic reviews have resulted, and 10 have recently been published in a special issue of Contraception (reviews in the issue involve intrauterine devices, regret after female sterilization, and a series of hormonal contraception topics, and are not listed separately in this column) (Peterson & Curtis, 2006). To complement the most recent editions of its contraception manuals, WHO makes updated guidance available on a web page (available from: http:// www.who.int/reproductive-health/family_planning/ 644 JOGNN
updates.html). Mohllajee et al. (2005) have described the system. REFERENCES Mohllajee, A. P., Curtis, K. M., Flanagan, R. G., Rinehart, W., Gafﬁeld, M. L., & Peterson, H. B. (2005). Keeping up with evidence: A new system for WHO’s evidence-based family planning guidance. American Journal of Preventive Medicine, 28, 483-490. Retrieved August 11, 2006, from http://download. journals.elsevierhealth.com/pdfs/journals/07493797/PIIS0749379705000668.pdf Peterson, H. B., & Curtis, K. M. (2006). The World Health Organization’s global guidance for family planning: An achievement to celebrate [Editorial]. Contraception, 73, 113-114. World Health Organization. (2004a). Medical eligibility criteria for contraceptive use (3rd ed.). Geneva, Switzerland: WHO. Retrieved August 11, 2006, from http://www.who.int/reproductive-health/publications/ mec/ World Health Organization. (2004b). Selected practice recommendations for contraceptive use (2nd ed.). Geneva, Switzerland: WHO. Retrieved August 11, 2006, from http://www.who.int/reproductive-health/ publications/spr/
From Cochrane Database of Systematic Reviews (CDSR), Issue 2, 2006 New Systematic Reviews • Chinese herbal medicine for the treatment of pre-eclampsia • Expectant care versus surgical treatment for miscarriage
© 2006, AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses
• Hepatitis B immunisation for newborn infants of hepatitis B surface antigen-positive mothers • Insecticide-treated nets for preventing malaria in pregnancy • Intravenous in-line ﬁlters for preventing morbidity and mortality in neonates • Mechanical devices for urinary incontinence in women • Prophylactic antibiotics for manual removal of retained placenta in vaginal birth • Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery • Recombinant human activated protein C for severe sepsis in neonates • Rest during pregnancy for preventing pre-eclampsia and its complications in women with normal blood pressure • Total versus subtotal hysterectomy
Updated Systematic Reviews • Developmental care for promoting development and preventing morbidity in preterm infants • Fluid and pharmacological agents for adhesion prevention after gynaecological surgery • Immunotherapy for recurrent miscarriage • Medical management for miscarriage • Oral misoprostol for induction of labour • Surgery versus medical therapy for heavy menstrual bleeding Cochrane Reviews are available by subscription to The Cochrane Library (see http://www.thecochranelibrary. com or contact [email protected]
for details). Abstracts of Cochrane Reviews are available without charge at http:// www.thecochranelibrary.com
From Database of Abstracts of Reviews of Effects (DARE) Recent Abstract Entries Assessing Quality of Systematic Reviews • Acupuncture for labor pain management: A systematic review • Delayed versus early pushing in women with epidural analgesia: A systematic review and meta-analysis • The effects of postmenopausal hormone therapies on female sexual functioning: A review of double-blind, randomized controlled trials • Management of uterine ﬁbroids • Prognostic value of the labour admission test and its effectiveness compared with auscultation only: A systematic review • Rates of caesarean section and instrumental vaginal delivery in nulliparous women after low concentration epidural infusions or opioid analgesia: Systematic review September/October 2006
• Second-trimester uterine artery Doppler screening in unselected populations: A review • Systematic review: Noninvasive testing for Chlamydia trachomatis and Neisseria gonorrhoeae • Treatment of vaginal infections to prevent preterm birth: A meta-analysis DARE abstracts are available without charge at http:// www.york.ac.uk/inst/crd/crddatabases.htm#DARE
Evidence-Based Reviews From Other Sources Featured review: Neri, M., Ugolini, D., Bonassi, S., Fucic, A., Holland, N., Knudsen, L. E., et al. (2006). Children’s exposure to environmental pollutants and biomarkers of genetic damage: II. Results of a comprehensive literature search and meta-analysis. Mutation Research: Reviews in Mutation Research, 612, 14-39. This systematic review of the association between in utero and childhood exposure to chemical environmental pollutants and biomarkers of genetic damage intermediate to the carcinogenesis process found elevated biomarker levels in exposed populations of mothers, newborns, and older children when compared with unexposed populations of mothers, newborns, and older children. The review presents data on urban air pollution; soil, air, and water pollution from industrial, agricultural, mining, and waste sources; in utero tobacco smoke exposure from maternal smoking; and in utero tobacco smoke exposure from environmental smoke. Comment: It is increasingly recognized that children may be more vulnerable to effects of toxic exposures than adults and that early exposures can have long-term consequences. Results of this review and uncertainties about many other exposures have far-reaching implications for policy, practice, research, and education. Featured reviews: (1) Kotaska, A. J., Klein, M. C., & Liston, R. M. (2006). Epidural analgesia associated with low-dose oxytocin augmentation increases cesarean births: A critical look at the external validity of randomized trials. American Journal of Obstetrics and Gynecology, 194, 809814; (2) Klein, M. C. (2006). Does epidural analgesia increase rate of cesarean section? Canadian Family Physician, 52, 419-421. Available without charge at http://www.cfpc. ca/cfp/2006/Apr/vol52-apr-editorials-2.asp Surveying 25 North American academic maternity units, Kotaska, Klein, and Liston found that low-dose oxytocin augmentation practices predominate, as recommended by leading North American obstetric societies. By contrast, they found that high-dose oxytocin protocols and other active management of labor features were used in seven of eight randomized controlled trials that compared epidural analgesia with parenteral opioids and JOGNN 645
reported oxytocin augmentation dosages and cesarean rates. In the low-dosage trial, which may be similar to current conditions in North America, the cesarean rate was much higher in the epidural than in the opioid group. In the remaining high-dosage trials, cesarean rates were lower, and group differences were not found. The authors hypothesize that high-dose oxytocin can counter the slowing effect of epidural analgesia on labor and avoid excess cesareans. Similarly, Klein carried out a subgroup analysis of the current Cochrane review of effects of epidural analgesia for labor pain. Although the overall review found no association between epidural and cesarean, analysis of the four trials in which women received it before active labor found that epidural was associated with increased likelihood of cesarean. Comment: Most women giving birth in the United States experience epidural analgesia, and its impact on cesarean delivery has been controversial. These reviews offer plausible explanations for discrepant research results and identify conditions that may inﬂuence this relationship.
Recent Evidence-Based Reviews • Akobeng, A. K., Ramanan, A. V., Buchan, I., & Heller, R. F. (2006). Effect of breast-feeding on risk of coeliac disease: A systematic review and metaanalysis of observational studies. Archives of Disease in Childhood, 91, 39-43. • Berger, J. S., Roncaglioni, M. C., Avanzini, F., Pangrazzi, I., Tognoni, G., & Brown, D. L. (2006.) Aspirin for the primary prevention of cardiovascular events in women and men: A sex-speciﬁc meta-analysis of randomized controlled trials. JAMA, 295, 306-313. • Buja, A., Mastrangelo, G., Perissinotto, G., Grigoletto, F., Frigo, A. C., Rausa, G., et al. (2006). Cancer incidence among female ﬂight attendants: A meta-analysis of published data. Journal of Women’s Health, 15, 98-105. • Castellsague, X., Diaz, M., de Sanjose, S., Monoz, N., Herrero, R., Franceschi, S., et al. (2006). Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: Implications for screening and prevention. Journal of the National Cancer Institute, 98, 303-315. • Feder, G. S., Hutson, M., Ramsay, J., & Taket, A. R. (2006). Women exposed to intimate partner violence: Expectations and experiences when they encounter health care professionals: A meta-analysis of qualitative studies. Archives of Internal Medicine, 166, 22-37. • Freeman, E. E., Weiss, H. A., Glynn, J. R., Cross, P. L., Whitworth, J. A., & Hayes R. J. (2006). Herpes simplex virus 2 infection increases HIV acquisition in men and women: Systematic review and meta-analysis of longitudinal studies. AIDS, 20, 73-83. 646 JOGNN
• Hartling, L., Chari, R., Friesen, C., Vandermeer, B., & Lacaze-Masmonteil, T. (2006). A systematic review of intentional delivery in women with preterm prelabor rupture of membranes. Journal of MaternalFetal and Neonatal Medicine, 19, 177-187. • Huxley, R., Barzi, F., & Woodward, M. (2006). Excess risk of fatal coronary heart disease associated with diabetes in men and women: Meta-analysis of 37 prospective cohort studies. BMJ, 332, 73-78. Available without charge at http://bmj.bmjjournals.com/ cgi/content/full/332/7533/73 • Langenbach, C. (2006). Misoprostol in preventing postpartum hemorrhage: A meta-analysis. International Journal of Gynecology and Obstetrics, 92, 10-18. • Magliano, D. J., Rogers, S. L., Abramson, M. J., & Tonkin, A. M. (2006). Hormone therapy and cardiovascular disease: A systematic review and meta-analysis. BJOG, 113, 5-14. • Martin, J. L., Williams, K. S., Abrams, K. R., Turner, D. A., Sutton, A. J., Chapple, C., et al. (2006). Systematic review and evaluation of methods of assessing urinary incontinence. Health Technology Assessment, 10, 1-132. Available without charge at http://www.hta.ac.uk/project.asp?PjtId=1213 • Murphy, V. E., Clifton, V. L., & Gibson, P. G. (2006). Asthma exacerbations during pregnancy: Incidence and association with adverse pregnancy outcomes. Thorax, 61, 169-176. • Myers, E. R., Bastian, L. A., Havrilesky, L. J., Kulasingam, S. L., Terplan, M. S., Cline, K. E., et al. (2006, February). Management of adnexal mass. Rockville, MD: Agency for Healthcare Research and Quality. Available with summary and without charge at http://www.ahrq.gov/clinic/tp/adrentp.htm • Nassar, N., Roberts, C. L., Barratt, A., Bell, J. C., Olive, E. C., & Peat, B. (2006). Systematic review of adverse outcomes of external cephalic version and persisting breech presentation at term. Paediatric and Perinatal Epidemiology, 20, 163-171. • Newman, L. A., Grifﬁth, K. A., Jatoi, I., Simon, M. S., Crowe, J. P., & Colditz, G. A. (2006). Meta-analysis of survival in African American and white American patients with breast cancer: Ethnicity compared with socioeconomic status. Journal of Clinical Oncology, 24, 1342-1349. • Nguyen, N. D., Eisman, J. A., & Nguyen, T. V. (2006). Anti-hip fracture efﬁcacy of bisphosphonates: A Bayesian analysis of clinical trials. Journal of Bone Mineral Research, 21, 340-349. • Owen, C. G., Martin, R. M., Whincup, P. H., DaveySmith, G., Gillman, M. W., & Cook, D. G. (2006). The effect of breastfeeding on mean body mass index throughout life: A quantitative review of published and unpublished observational evidence. American Journal of Clinical Nutrition, 82, 1298-1307. Volume 35, Number 5
• Pinquart, M., & Sörensen, S. (2006). Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 61, P33-P45. • Say, L., Donner, A., Gülmezoglu, A. M., Taljaard, M., & Piaggio, G. (2006). The prevalence of stillbirths: A systematic review. Reproductive Health, 3, 1. Available at http://www.reproductive-health-journal.com/ content/3/1/1 • Shipman, S. A., Helfand, M., Moyer, V. A., & Yawn, B. P. (2006). Screening for developmental dysplasia of the hip: A systematic literature review for the US Preventive Services Task Force. Pediatrics, 117, e557e576. Available without charge at http://pediatrics. aappublications.org/cgi/content/full/117/3/e557 • Szajewska, H., Horvath, A., Koletzko, B., & Kalisz, M. (2006). Effects of brief exposure to water, breastmilk substitutes, or other liquids on the success and duration of breastfeeding: A systematic review. Acta Paediatrica, 95, 145-152.
• Varma, R., & Gupta, J. K. (2006). Antibiotic treatment of bacterial vaginosis in pregnancy: Multiple meta-analyses and dilemmas in interpretation. European Journal of Obstetrics, Gynecology and Reproductive Biology, 124, 10-14. • Varma, R., Sinha, D., & Gupta, J. K. (2006). Noncontraceptive uses of levonorgestrel-releasing hormone system (LNG-IUS): A systematic enquiry and overview. European Journal of Obstetrics, Gynecology and Reproductive Biology, 125, 9-28. • Xiong, X., Buekens, P., Fraser, W. D., Beck, J., & Offenbacher, S. (2006). Periodontal disease and adverse pregnancy outcomes: A systematic review. BJOG, 113, 135-143.
Carol Sakala, PHD, MSPH, is director of programs at Childbirth Connection (formerly Maternity Center Association), which works with health professionals and other audiences to promote evidencebased maternity care (http://www.childbirthconnection.org). E-mail: [email protected]