Complementary medicines and therapies in clinical guidelines on pregnancy care: A systematic review
Women Birth. 2021 Aug 18;S1871-5192(21)00141-4. doi: 10.1016/j.wombi.2021.08.003
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Carolyn Ee 1, Kate Levett 2, Caroline Smith 3, Mike Armour 4, Hannah G Dahlen 5, Prakshi Chopra 6, Paulette Maroun 7, Vibhuti S Rao 8, Nicole Avard 9, Suzanne Grant 10, Hazel Keedle 11, Susanne Armour 12, Susan Arentz 13, Adele E Cave 14, Kerry Sutcliffe 15, Kate Templeman 16
Pregnancy-specific recommendations
- Call to action – more Vitamin D for pregnancies, loading doses are OK – Holick Aug 2019
- Pregnancy recommendations – huge differences in Vitamin D, Mg, iron, Iodine, DHA, etc – April 2021
- WHO recommends zero vitamin D during pregnancy, rest of the world disagrees – 2018, 2020
Recommendations for adults, including pregnant
- Vitamin D restoration then monthly was the most popular dosing by trials – Nov 2018
- Minimum National Vitamin D recommendations range from 200 to 4,000 IU – July 2021
- Need 40 to 60 ng of Vitamin D – 48 scientists call for action – 2015
- 4,000 IU of Vitamin D is OK - 19 organizations agree - 2018
Pregnancy category starts with
- see also
- Overview Pregnancy and vitamin D
- Number of articles in both categories of Pregnancy and:Dark Skin
30 ; Depression 21 ; Diabetes 44 ; Obesity 17 ; Hypertension 44 ; Breathing 36 ; Omega-3 44 ; Vitamin D Receptor 24 Click here for details - All items in category Infant/Child
854 items - Pregnancy needs at least 40 ng of vitamin D, achieved by at least 4,000 IU – Hollis Aug 2017
- 38+ papers with Breastfed etc, in the title
- Call to action – more Vitamin D for pregnancies, loading doses are OK – Holick Aug 2019
- 53+ preeclampsia studies
- 94+ studies with PRETERM in the title
- Fertility problem (PCOS) reduced by vitamin D, etc: many studies 15+
- 94+ Gestational Diabetes
- Caesarean birth much more likely if low Vitamin D - many studies 15+ studies
- Post-partum depression and low Vitamin D - many studies 15+ studies
- Stillbirth reduced by Vitamin D, Zinc, Omega-3 - several studies 5+ studies
- Search VitaminDWiki for "Assisted reproduction" 33 items as of Aug 2022
- Fertility and Sperm category listing has
142 items along with related searches - (Stunting OR “low birth weight” OR LBW) 1180 items as of June 2020
- Less labor pain if higher level of vitamin D – August 2021
- Healthy pregnancies need lots of vitamin D
- Ensure a healthy pregnancy and baby - take Vitamin D before conception
Healthy pregnancies need lots of vitamin D has the following summary
Most were taking 2,000 to 7,000 IU daily for >50% of pregnancy
Click on hyperlinks for detailsProblemVit. D
ReducesEvidence 0. Chance of not conceiving 3.4 times Observe 1. Miscarriage 2.5 times Observe 2. Pre-eclampsia 3.6 times RCT 3. Gestational Diabetes 3 times RCT 4. Good 2nd trimester sleep quality 3.5 times Observe 5. Premature birth 2 times RCT 6. C-section - unplanned 1.6 times Observe Stillbirth - OMEGA-3 4 times RCT - Omega-3 7. Depression AFTER pregnancy 1.4 times RCT 8. Small for Gestational Age 1.6 times meta-analysis 9. Infant height, weight, head size
within normal limitsRCT 10. Childhood Wheezing 1.3 times RCT 11. Additional child is Autistic 4 times Intervention 12.Young adult Multiple Sclerosis 1.9 times Observe 13. Preeclampsia in young adult 3.5 times RCT 14. Good motor skills @ age 3 1.4 times Observe 15. Childhood Mite allergy 5 times RCT 16. Childhood Respiratory Tract visits 2.5 times RCT RCT = Randomized Controlled Trial
Background: There is a need for evidence-based guidance on complementary medicines and therapies (CMT) use during pregnancy due to high prevalence of use and lack of guidance on the balance of benefit and harms.Aim: Evaluate the extent to which current clinical practice guidelines relevant to Australian healthcare professionals make clear and unambiguous recommendations about CMT use in pregnancy, and synthesise these recommendations.
Methods: The search included EMBASE, PubMed, the National Health and Medical Research Council's Clinical Practice Guidelines Portal, and websites of Australian maternity hospitals and professional/not-for-profit organisations for published guidelines on pregnancy care. Data were synthesised narratively. Guidelines were appraised by two independent reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.
Findings: A total of 48 guidelines were found, of which 41% provided recommendations that were not limited to routine vitamin and mineral supplementation. There were wide variations in recommendations, particularly for vitamin D and calcium. There was some consensus on recommending ginger and vitamin B6 for nausea and vomiting, and additional supplementation for women with obesity. Guidelines generally scored poorly in the domains of editorial independence and rigour of development.
Discussion: There is a lack of guidance with regard to appropriate CMT use during pregnancy, which may result in less-than-optimal care. Inconsistency between guidelines may lead to variations in care.
Conclusion: Guidelines should include clear and unambiguous guidance on appropriate CMT use during pregnancy, be based on a structured search of the evidence and informed by stakeholder engagement.
Wide variation in vitamin D recommendations (in this case, pregnant in Australia) – Aug 2021Printer Friendly Follow this page for updates3297 visitors, last modified 23 Aug, 2021, This page is in the following categories (# of items in each category) - All items in category Infant/Child