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采用改良 Delphi 法对妇产科补充治疗作用的专家共识。

Expert consensus on the role of supplementation in obstetrics and gynecology using modified delphi method.

机构信息

Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.

Obstetrics and Gynecology, Al Kasr Al Aini, Cairo University, Cairo, Egypt.

出版信息

Arch Gynecol Obstet. 2024 Feb;309(2):639-650. doi: 10.1007/s00404-023-07310-3. Epub 2023 Dec 28.

Abstract

PURPOSE

To reach a consensus among obstetrics and gynecology experts on the effects of micronutrient supplementation on fertility and pregnancy to aid clinicians in decision-making and create a unified approach to managing micronutrient deficiencies in women, by performing a modified Delphi study.

METHODS

A three-round modified Delphi process was conducted among a Delphi panel of 38 Egyptian experts to define recommendations regarding the role of supplementation on fertility and pregnancy in women of reproductive age. A literature review was performed and supporting evidence was graded to help guide the recommendations based on available evidence.

RESULTS

A total of 62 statements were developed for discussion and voting. Out of the 62 statements, 60 statements reached expert consensus. Statements were divided into two domains. The first domain discussed the role of supplementation in fertility: optimizing natural fertility, polycystic ovary syndrome (PCOS), in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), unexplained infertility, and endometriosis, whereas the second domain was concerned with the role of supplementation in pregnancy during the prenatal, antenatal, and postnatal periods.

CONCLUSION

In this work, a modified Delphi methodology was implemented to reach a consensus on the use of micronutrient supplementation in women of reproductive age. These recommendations can help clinicians in their practice, guide future research, and identify gaps in the market for the pharmaceutical industry. This clinical guidance can be extrapolated to similar communities.

摘要

目的

通过进行改良德尔菲法研究,在妇产科专家中就微量营养素补充对生育力和妊娠的影响达成共识,以帮助临床医生做出决策并制定统一的方法来管理女性的微量营养素缺乏。

方法

对 38 名埃及专家组成的德尔菲小组进行了三轮改良德尔菲法研究,以确定关于补充剂对育龄妇女生育力和妊娠作用的建议。进行了文献复习,并对支持证据进行了分级,以根据现有证据为建议提供指导。

结果

共提出了 62 项用于讨论和投票的陈述。在这 62 项陈述中,有 60 项陈述达成了专家共识。陈述分为两个领域。第一个领域讨论了补充剂在生育力方面的作用:优化自然生育力、多囊卵巢综合征(PCOS)、体外受精/胞浆内精子注射(IVF/ICSI)、不明原因不孕和子宫内膜异位症,而第二个领域则涉及补充剂在产前、产时和产后期间对妊娠的作用。

结论

在这项工作中,采用改良德尔菲法就育龄妇女使用微量营养素补充达成了共识。这些建议可以帮助临床医生在实践中应用,指导未来的研究,并为制药行业发现市场空白。这种临床指导可以推广到类似的社区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cd0/10808492/9655ed83d207/404_2023_7310_Fig1_HTML.jpg

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