Comparison and appraisal of (inter)national recurrent pregnancy loss guidelines

Youssef, Angelos; Vermeulen, Nathalie; Lashley, Eileen; Goddijn, Mariëtte; Hoorn, Marie-Louise van der

doi:10.1016/j.rbmo.2019.04.008

Cited by 66 publications

(56 citation statements)

References 17 publications

(15 reference statements)

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“…There were many pathogeneses of RPL, including chromosomal abnormalities, autoimmune diseases, anti-phospholipid antibodies, endocrinological abnormalities, thrombophilia disorders and uterine abnormalities. Nearly half of these pregnancy loss reasons need to be explored as well as their psychological and psychiatric effects [2,17]. Women with RPL commonly develop post-traumatic stress disorder, anxiety, depression and other negative psychological problems after pregnancy losses [18].…”

Section: Discussionmentioning

confidence: 99%

Anxiety and Depression Are Risk Factors for Recurrent Pregnancy Loss: A Nested Case-control Study

Wang

Meng

Pei

et al. 2020

Preprint

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Background: To evaluate the depression–anxiety interaction with the development of recurrent pregnancy loss (RPL). Methods: A nested case–control study involving 2,558 participants was conducted with data from the prospective Miscarriage Woman Cohort study between 2017 and 2019 in the province of Gansu, China. The questionnaire data, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale were collected after each participant’s first miscarriage. Information on RPL outcomes was obtained from the medical records within the subsequent two years. The logistic regression and the addition and multiplication interaction effects between anxiety and depression to RPL were analysed.Results: The prevalence of anxiety (28.7% vs. 19.5%) and depression symptoms (48.6% vs. 41.3%) for the 1,132 RPL cases were higher than 1,426 non-RPL controls (P< 0.001). After adjustment for possible confounding variables, compared with the non-RPL participants without depression and anxiety symptoms, the odds ratio (OR) value, reflecting the multiplicative interaction, was 2.788 (95%CI: 1.511–5.144, P < 0.001) for cases with both anxiety and depression symptoms. Moreover, among these, the OR for cases with mild anxiety and severe depression was 5.369 (95%CI: 1.074–26.832, P < 0.001), and the OR for cases with severe anxiety and mild depression was 5.339 (95%CI: 1.033–27.590, P < 0.001). The relative excess risk of interaction value (RERI), reflecting the additive interaction between anxiety and depression to RPL was also 1.148 (95%CI: 0.316–4.212).Conclusions: Either depression or anxiety alone could increase risk of subsequent RPL. There also was a synergistic effect of anxiety and depression after the first miscarriage that increased the development of subsequent RPL disease.

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Section: Discussionmentioning

confidence: 99%

Anxiety and Depression Are Risk Factors for Recurrent Pregnancy Loss: A Nested Case-control Study

Wang

Meng

Pei

et al. 2020

Preprint

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“…There have been many reports on the pathogeneses of RPL, including chromosomal abnormalities, autoimmune diseases, antiphospholipid antibodies, endocrinological abnormalities, thrombophilia disorders and uterine abnormalities [1][2][3]. Nearly half of the aforementioned reasons for pregnancy loss should be explored along with their psychological and psychiatric effects [2,17]. RPL has a remarkable emotional and psychological in uence on women of child-bearing age and their families [2].…”

Section: Discussionmentioning

confidence: 99%

Anxiety and depression are risk factors for recurrent pregnancy loss: A nested case-control study

Wang

Meng

Pei

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: To evaluate the interaction of depression and anxiety with the development of recurrent pregnancy loss (RPL).Methods: A nested case–control study involving 2,558 participants was conducted with data from the prospective Miscarriage Woman Cohort study between 2017 and 2019 in the province of Gansu, China. The questionnaire data, self-rating anxiety scale and self-rating depression scale were collected after each participant’s first miscarriage. Information on RPL outcomes was obtained from the medical records within the subsequent two years. All patients diagosed RPL were recruited as cases whilst a randomly selected group of women with only one miscarriage in the past were recruited as controls. The logistic regression and the interaction effects between anxiety and depression and RPL were analysed.Results: The prevalence of anxiety (n=325, 28.7% vs. n=278, 19.5%) and depression symptoms (n=550, 48.6% vs. n=589, 41.3%) for the 1,132 RPL cases were higher than 1,426 non-RPL controls (P< 0.001). After adjusting for possible confounding variables, the odds ratio (OR) value, reflecting the multiplicative interaction, was 1.91 (95% CI: 1.50–2.44, P<0.001) for cases with both anxiety and depression symptoms compared with the non-RPL group. The relative excess risk of interaction value, reflecting the additive interaction between anxiety and depression to RPL was 1.15 (95% CI: 0.32–4.21). Moreover, the adjusted OR for RPL cases with mild anxiety and severe depression was 2.77 (95% CI:1.07-44.14, P<0.001) , for RPL cases with severe anxiety and mild depression was 4.23 (95% CI: 1.01–22.21, P<0.001), for RPL cases with severe anxiety and moderate depression was 4.34 (95% CI: 1.03–21.28, P<0.001) and for RPL cases with severe anxiety and severe depression was 5.95 (95% CI: 1.09–45.09, P<0.05).Conclusions: Either depression or anxiety alone could increase the risk of subsequent RPL. Anxiety and depression had a synergistic effect after the first miscarriage which increased the development of subsequent RPL disease.

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“…These included high priority health topics such as induction of labor [26], planned cesarean Sect. [27], recurrent pregnancy loss [28], packed red cells versus whole blood transfusion for severe pregnancy-related anemia and obstetric bleeding [29], gestational diabetes mellitus [30][31][32], and bladder pain syndrome/interstitial cystitis [33]. These studies identified several gaps, including differences, discrepancies, lack of evidence-base, and inconsistencies in some clinical recommendations among the CPGs; in addition, a few commonalities and similarities in some recommendations with advice to improve these variabilities were observed in CPGs [26][27][28][29][30][31][32][33].…”

Section: Domain 6 Editorial Independencementioning

confidence: 99%

Quality assessment of evidence-based clinical practice guidelines for the management of pregnant women with sickle cell disease using the AGREE II instrument: a systematic review

Amer

Elgohary

Altaki

et al. 2020

BMC Pregnancy Childbirth

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Background The management of pregnant women with sickle cell disease (SCD) poses a major challenge for maternal healthcare services owing to the potential for complications associated with morbidity and mortality. Trustworthy evidence-based clinical practice guidelines (CPGs) have a major impact on the positive outcomes of appropriate healthcare. The objective of this study was to critically appraise the quality of recent CPGs for SCD in pregnant women. Methods Clinical questions were identified and the relevant CPG and bibliographic databases were searched and screened for eligible CPGs. Each CPG was appraised by four independent appraisers using the AGREE II Instrument. Inter-rater analysis was conducted. Results Four eligible CPGs were appraised: American College of Obstetricians and Gynecologists (ACOG), National Heart, Lung, and Blood Institute (NHLBI), National Institute of Health and Care Excellence (NICE), and Royal College of Obstetricians and Gynaecologists (RCOG). Among them, the overall assessments of three CPGs (NICE, RCOG, NHLBI) scored greater than 70%; these findings were consistent with the high scores in the six domains of AGREE II, including:[1] scope and purpose,[2] stakeholder involvement,[3] rigor of development,[4] clarity of presentation,[5] applicability, and [6] editorial independence domains. Domain [3] scored (90%, 73%, 71%), domain [5] (90%, 46%, 47%), and domain [6] (71%, 77%, 52%) for NICE, RCOG, and NHLBI, respectively. Overall, the clinical recommendations were not significantly different between the included CPGs. Conclusions Three evidence-based CPGs presented superior methodological quality. NICE demonstrated the highest quality followed by RCOG and NHLBI and all three CPGs were recommended for use in practice.

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Comparison and appraisal of (inter)national recurrent pregnancy loss guidelines

Abstract: is a 23-year-old medical student, who is combining research with his medical internship. His intention is to become a dedicated gynaecologist. He has already carried out several studies on recurrent pregnancy loss (RPL) and will be investigating RPL as a future PhD student.

Cited by 66 publications

References 17 publications

Anxiety and Depression Are Risk Factors for Recurrent Pregnancy Loss: A Nested Case-control Study

Anxiety and Depression Are Risk Factors for Recurrent Pregnancy Loss: A Nested Case-control Study

Anxiety and depression are risk factors for recurrent pregnancy loss: A nested case-control study

Quality assessment of evidence-based clinical practice guidelines for the management of pregnant women with sickle cell disease using the AGREE II instrument: a systematic review

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