García-Valdés Luz, Al Wattar Bassel H, García-Valdés Mar, Amezcua-Prieto Carmen
Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.
Beginnings Assisted Conception Unit, Epsom and St Helier University Hospitals, London, United Kingdom.
Eur J Public Health. 2025 Jun 1;35(3):423-433. doi: 10.1093/eurpub/ckaf046.
The Coronavirus Disease 2019 (COVID-19) pandemic disrupted maternity care, highlighting the need for rapid, high-quality clinical practice guidelines (CPGs) to ensure safe care for pregnant women. We assessed the quality and recommendations of CPGs related to COVID-19 in pregnancy. Following prospective registration (PROSPERO number: CRD42022346031) we searched Medline, Web of Science, and UpToDate from inception until July 2024. The methodological quality was appraised using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). A total of 27 CPGs were included. High scores were achieved in scope and purpose (21/27, 78%) and clarity (17/27, 63%). The most poorly addressed domains were rigour of development and applicability to clinical practice (18/27, 67% and 19/27, 70% scored low quality, respectively). Overall, only four (15%) guidelines were recommended. Most CPGs (25/27, 93%) addressed COVID-19 screening and transmission prevention, but few covered psychological care (3/27, 11%) or maternal delivery preferences (4/21, 19%). Consensus was found on timing and mode of delivery (16/17, 94%), but there was disagreement on delayed cord clamping and virus transmission interventions. Evidence-based practice requires health care providers, patients and stakeholders to be aware of variations in both the quality and recommendations of CPGs, especially during times of uncertainty.
2019年冠状病毒病（COVID-19）大流行扰乱了孕产妇护理，凸显了制定快速、高质量临床实践指南（CPG）以确保为孕妇提供安全护理的必要性。我们评估了与孕期COVID-19相关的CPG的质量和建议。在进行前瞻性注册（PROSPERO编号：CRD42022346031）后，我们检索了从创刊至2024年7月的Medline、科学网和UpToDate。使用《研究与评价指南评估II》（AGREE II）对方法学质量进行评估。共纳入27份CPG。在范围和目的（21/27，78%）以及清晰度（17/27，63%）方面获得了高分。处理最不完善的领域是制定的严谨性和对临床实践的适用性（分别有18/27，67%和19/27，70%的得分质量较低）。总体而言，仅推荐了4份（15%）指南。大多数CPG（25/27，93%）涉及COVID-19筛查和传播预防，但很少涉及心理护理（3/27，11%）或产妇分娩偏好（4/21，19%）。在分娩时间和方式上达成了共识（16/17，94%），但在延迟脐带结扎和病毒传播干预措施上存在分歧。循证实践要求医疗保健提供者、患者和利益相关者了解CPG在质量和建议方面的差异，尤其是在不确定时期。
