Prevention and Treatment of Non-Communicable Diseases in Antenatal, During and Postnatal Care: An Overview of the Scientific Scope of Indicators for Scientific Observation Since 2011 | BMC . Medicines

The database searches for 6026 distinct data (PRISMA traffic diagram is presented in Figure 1). 1,511 were identified by examining potentially relevant titles and abstracts, of which 357 were recognized as eligible for inclusion. Internet searches of 165 organizations, associations, and schools identified 48 additional qualifying indicators. In full, 405 indicators are included in this overview (Office 1).

Figs. 1

2020 PRISMA motion chart of the research path conducted to identify eligible indicators, with a variety of data considered or excluded in each stage of the method. The database searches recognized 6,026 distinct data, of which 357 were recognized as eligible for inclusion after screening by two neutral reviewers. Internet searches of 165 organizations, associations, and schools identified 48 additional qualifying indicators. In the end, 405 indicators are included in this overview.

From:

Webpage M Gee, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 Affirmation: An Up-to-Date Guide to Reporting Systematic Criticisms. BMJ 2021; 372: n71

Desk 1 Attributes of Embedded Scientific Observation Indicators

Attributes of Embedded Pointers

A summary of the attributes of pointers included in Desk 1 is given, and an additional detailed office of attributes is given in Supplementary File 5: Desk 1. Of the 405 pointers, it was 132 of them were pregnancy-specific and 273 were primary screening indices. In total, 246 (61%) indicators were printed between 2016 and 2021, and the best variety of indicators printed in one year was in 2019 ( n = 53) (Fig. 2). The countries with the highest diversity of released indices were the United States of America (USA) (

n = 88), United Kingdom (UK) (

n = 47) Canada ( n = 29) Australia ( n

= 22) and Italy ( n = 11). The vast majority of the indicators were from high-income countries (HICs,

n = 285), while the remaining 39 indicators were from middle-income countries (MICs), mostly from Brazil (n = 9), China ( ) n

= 6), Malaysia (

n

= 6), Thailand (n
= 3). The different middle-income countries were Georgia, India, South Africa, Argentina, Colombia, Costa Rica, Iran, Kenya, and Romania. There were no recognized indicators of low-income countries. Indexes have been printed by a variety of organizations, along with medical specialty associations and organizations from the USA ( n = 67) Europe (

n = 52), the British National Institute for Wellbeing and Care Excellence (NICE) (figure 1 n

= 11).

Figs. 2

figure 1

A variety of basic and specific scientific indications for pregnancy by year of publication. The included indicators were categorized into two broad domains – 'pregnancy-specific' indicators (that is, the base range relates only to the management of pregnant, intrapartum or postpartum women) or 'core' indicators (that is, indicate where the range is associated with the management of adult NCD cases) or in a number of population teams, which included certain sections on non-communicable diseases related to antenatal, intrapartum, or postpartum care). In total, 246 (61%) indicators were printed between 2016 and 2021, and the best variety of indicators printed in one year was in 2019 ( n

= 53)

Distribution of indicators by disease category and condition

Quantity and distribution of indicators are described by disease category and status for pregnancy – specific indicators and basic (Figs 3 and 4, respectively). In the indications for pregnancy, the most common conditions for which suggestions were made were GDM, various circulatory diseases, thyroid problems, hypertensive problems during pregnancy, underlying cardiovascular disease, and depression problems. For baseline indicators, prevalent conditions were various circulatory diseases, cervical cancers, thyroid problems, inflammatory bowel disease, and migraine/headache. Of the many 39 indices printed from MICs, 13 were specific to pregnancy, and the indicators generally provided suggestions for cardiovascular disease [15,16,17,18,19,20], GDM [21,22,23,24, 25] and rheumatoid arthritis [26] and a number of sclerosis [21].

Figs. 3

Distribution of scientific observation indicators for pregnancy by disease category. The included indications were categorized as 'pregnancy-specific indications' if the scope of the rule pertained only to the management of pregnant, intrapartum or postpartum women. The most common disease categories lined by pregnancy-specific indicators were cardiovascular disease, psychiatric and substance abuse problems, and diabetes mellitus.

figure 4Figs. 4

Distribution of basic scientific observation indicators by disease category. Included indicators were classified as 'core indicators' if the range related to management of NCD cases in adults or in all population teams, which included specific sections on NCDs associated with prenatal, intrapartum, or postnatal care. The most common disease categories lined up by primary indicators were endocrine/blood/immune problems, malignancies, and cardiovascular disease

Mapping proposals for high-priority non-communicable disease conditions

47 completed Indicator. Recognized and associated with high priority non-communicable disease conditions endorsed by the WHO professional group. From these, we extracted 1,834 specific personal suggestions.

Diabetes (GDM and pre-existing)

complete, 19 indicators [21,22,23,24,25, 27,28,29,30,31,32,33,34,35,36,37,38, 39,40] printed between 2013 and 2019 provides suggestions for GDM (Office 2). Indicators from a global or regional structure were issued by the Endocrine Society [29], the World Health Organization [30] and the International Federation of Obstetrics and Gynecology (FIGO) [35] and the Asociación Latinoamericana de Diabetes [33] (ALAD). The remaining indices were from the USA [27, 28, 38], the UK [36, 37], Germany [32], New Zealand [39], Australia [31], and Canada [34], and 6 indices were from middle-income countries. (India [21], China [23, 72], Chile [40], Georgia [25], Malaysia [24] and Thailand [22]). From 19 indicators, we extracted 449 suggestions, of which 299 (67%) were for screening/diagnosis or scientific interventions at all stages of antenatal care, 52 (12%) for intrapartum care, and 89 (20%) for postnatal care ( Supplementary file 6: office 1), and eight were for welfare system interventions. A number of indications line the approach to GDM screening (joint screening or screening of high-risk women only), as well as the timing and/or type of screening Check up during each prenatal and postnatal care. Medical interventions included acceptable use of pharmacological treatments, lifestyle training (largely rounded diet and weight management), and acceptable care throughout labor and initiation (eg, method and timing of supply). More than half of the indicators provided suggestions for self-monitoring and glycemic goals throughout pregnancy, and indications for lactation. Wellbeing Technologies suggestions are lined with multidisciplinary care, auditing, and laboratory testing requirements. When assessing indicators from high-income versus middle-income countries, the base range and the interventions shown were broadly comparable.

Office 2 Medical Surveillance Indicators for Initial Priority Conditions

4 indicators [31, 36, 37, 41] printed between 2015 and 2019 provide suggestions for managing pre-existing diabetes (Office 2). All indices have been printed in high-income countries by government or medical societies, plus two have been released within the UK (NICE [37] and the British Joint Diabetes Societies [36]), and one from the USA (American School of Obstetrics and Gynecology, ACOG [41]) and one from Australia [31]. A total of 283 proposals were identified across all indices. Slightly less than half of those associated with interventions by the antenatal period (45%), adopted during childbirth (34%), and the postnatal interval (19%). Only three suggestions were recognized for welfare system interventions, masking aspects of coverage and workforce welfare. Suggestions for screening and scientific interventions, along with forms of testing and use of frequent testing, recommendation/lifestyle coaching, drug therapy, glucose monitoring and glycemic goals, initial planning, referrals, and new pediatric care, are complete (Supplementary File 6: Desk 2).

Hypertension

We identified 10 indicators [16, 20, 42,43,44,45,46,47,48,49] printed between 2014 and 2021 that provide suggestions for managing hypertension Continuous (Office 2). Only one guideline printed by ACOG [47] was specifically developed on the administration of persistent hypertension during pregnancy, while the remaining indications were broadly targeted at hypertensive problems in pregnancy. All indications have been issued by medical societies, mostly from all over the world (World Society for Screening Hypertension in Pregnancy [45]) or high-income countries corresponding to Australia/New Zealand [50 France [43], Canada [44], Poland [ 46] USA [47], Air [48] and Sweden [49]. Two indicators were recognized from middle-income countries – China and Thailand [16, 20]. From the ten indicators, we extracted 143 suggestions, which were mainly related to antenatal care (70%) and postnatal care (15%), and the remaining suggestions were related to wellness techniques interventions and intrapartum interval. The range of suggestions provided guidance for definitions and threshold values ​​for analysis, acceptable use of antihypertensive therapy, and blood stress targets (Supplementary File 6: Office 3). Most suggestions, notably during the postpartum period and during childbirth, were few and were never supported by more than two indicators. Indicators from middle-income countries (China and Thailand) were broadly comparable in scope and aligned interventions compared to high-income countries.

Respiratory conditions

Two indicators made suggestions for the management of bronchial asthma (Office 2), printed in Australia [50] and the United Kingdom [51]. The baseline from Australia targ bronchial asthma only has been identified (74 suggestions), while the rule from the UK targets intrapartum care after the prevalence of existing medical conditions, along with bronchial asthma (two suggestions). Of the 76 recognized proposals for bronchial asthma, 54 (71%) were for antenatal care, 20 (26%) for intrapartum care, and two (3%) for postnatal care (Supplementary File 6: Office 4). Welfare scheme proposals are not recognized. The main focus of the suggestions was varied and was mostly scientific interventions corresponding to the recommendation for management of bronchial asthma, parts of routine care (eg, monitoring by severity and management, determining frequency of appointments required, treatment overview, inhaler method examination), pharmacotherapy, case management Certain related to acute exacerbations, or poorly managed bronchial asthma. Indications for the management of persistent obstructive pulmonary disease are not recognized.

One of the guidelines printed in 2011 by the Royal School of Obstetricians and Gynecologists [52] offered 136 suggestions for the management of sickle cell disease in a pregnant woman (Desk 2, Supplementary File 6: Desk 5). A full range of suggestions were made for screening (type of assessments and examinations), scientific care (eg, parts of routine care, pharmacotherapy, acute pain management, initiation of planning), and well-being system interventions (eg, use of science protocols, well-being workforce, and referral pathways). No indications for the management of hemoglobin diseases have been recognized.

Psychological problems and substance abuse

A full set of 20 indicators of psychological problems and substance use problems were identified, which provided suggestions for underlying psychological problems, bipolar dysfunction or psychotic problems [53,54,55]. ,56,57,58], despair and anxiety [53,54,55, 58,59,60,61,62,63, 67], substance abuse problems [56, 58, 64, 65, 66,67,68] Alcohol use problems [58, 65, 69, 70, 71], and tobacco use [65, 67, 68] (Office 2, Supplementary file 6: Tables 6-10). All indicators are developed by our bodies worldwide [30, 57, 69] or from high-income countries (Australia and/or New Zealand [53, 58, 59, 60, 65], Canada [55, 56, 62, 68]). USA [61, 63, 64], and Scotland [54]).

in full, 81 suggestions related to primary mood problems, bipolar impairment, psychotic dysfunction, schizophrenia, and threatened suicide and infanticide (Additional File 6: Office 6). Suggestions for screening during the antenatal and postnatal period included assessment through the private or household historical past, and the use of the Edinburgh Postpartum Depression Scale (EPDS) for pregnant adolescents. Medical interventions line up in the case of an individualized treatment plan, drug therapy, and referrals to psychiatric providers. On the welfare system score, the involvement of multidisciplinary care staff (psychiatrists, gynecologists, pediatricians and midwives) was beneficial. One of the guidelines identified the necessity of a nationally managed scientific community for perinatal psychological well-being that should coordinate provision of providers, establish pathways for referral and management, and establish competencies and training assets for health professionals. No suggestions specifically related to the time interval during childbirth have been recognized.

for despair and anxiety, 256 suggestions for psychosocial assessment using tools corresponding to EPDS, pharmacotherapy (risk-benefit assessment, treatment overview, and dose adjustment), psychotherapy (eg, cognitive behavioral therapy, Interpersonal psychotherapy) (Additional File 6: Office 7). Suggestions for girls under excessive threat—consistent with suicidal tendencies or severely depressed—included involvement of associate help, and acceptable use of home treatment or hospitalization. Additional scientific evaluation was helpful additionally, along with referral to psychiatric providers, actively supporting women to benefit from psychiatric providers and counseling interventions. Through the postpartum period, breastfeeding suggestions included feasible indications and risks related to drug therapy. Furthermore, neonatal observational suggestions for outcomes lined up An antidote related to maternal use of psychotherapy mediators. With regard to the degree of the welfare system, the proposals target the availability of local indicators, the establishment of competencies of welfare suppliers, the availability of a particular service for analysis and treatment, and the provision of training and training for welfare professionals.

The breadth of interventions for drug use problems varies by substance type (Additional File 6: Office 8). A full 186 proposals line up in interventions for routine examination and evaluation, as well as special suggestions for the management of women who use amphetamines, benzodiazepines, cannabis, opioids, and psychostimulants. Compared to the various high-priority settings, well-being techniques accounted for a relatively greater proportion of suggestions (12%) and ranked the roles of case managers in coordinating care among a number of caregivers (drug and alcohol providers, home help providers, and primary caregivers). Practitioners, probation and parole providers, group care organizations), legal reporting, liaison with small safety firms, and ensuring providers provide treatment and relapse safety packages.

For tobacco use, two indicators have been identified that give 33 suggestions (Supplementary File 6: Office 9). For alcohol use problems, six indicators were identified offering 122 suggestions (Additional File 6: Office 10). Suggestions line up primarily on scientific screening and interventions through the antenatal and postnatal periods. For tobacco use, suggestions included common assessment of smoking cessation, training of mothers on the hazardous consequences of smoking, recommendation for smoking cessation, partnering with companions for help, offering psychosocial interventions and/or pharmacotherapy, and methods for relapse prevention and management. For alcohol use problems, screening with validated questionnaires such as verification to identify alcohol use problems was helpful, as well as interventions to provide recommendation on abstinence, management of alcohol withdrawal syndrome, breastfeeding indications, assessments and monitoring for fetal alcohol spectrum imbalance . For each case, welfare system proposals included providing some availability and access for providers of prevention and management during current sexual, reproductive and child care, or through community-based interventions. There were no useful scientific interventions during the intrapartum period.

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