quality of guidelines on the management of diabetes in pregnancy a systematic review质量方针在妊娠糖尿病的管理系统回顾.pdfVIP

Greuter et al. BMC Pregnancy and Childbirth 2012, 12:58 /1471-2393/12/58 RESEARCH ARTICLE Open Access Quality of guidelines on the management of diabetes in pregnancy: a systematic review 1 1 2 1* Marjolein JE Greuter , Nathalie MA van Emmerik , Maurice GAJ Wouters and Maurits W van Tulder Abstract Background: Diabetes during pregnancy can lead to severe risks for both mother and fetus when it is not managed properly. The use of rigorously developed guidelines with a robust implementation process can have a positive influence on the management of diabetes during pregnancy. This study aims to compare recommendations and assess the quality of clinical guidelines on gestational diabetes mellitus (GDM) and pre-existing diabetes mellitus during pregnancy. Methods: Guidelines were selected by searching PubMed, the Guideline Clearing House and Google. All guidelines developed since 2000 on diabetes during pregnancy in English or Dutch were considered. Recommendations of the guidelines were compared. Furthermore, the quality was assessed by two authors independently, using the AGREE instrument. Results: Eight guidelines were included. According to the AGREE instrument, the quality of most guidelines was low. The domains editorial independence, stakeholder involvement and rigour of development had the lowest scores. Recommendations were mainly comparable on glycemic control, preconceptional counseling and prenatal care and labour. Differences between recommendations were found for screening on GDM and induction of labour. Conclusions: The quality of most guidelines concerning the management of diabetes during pregnancy needs to be improved. A more systematic approach in the dev