Journal of Midwifery & Women’s Health

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Evidence-Based Practice

Current Resources for Evidence-Based Practice, March/April 2015 Nicole S. Carlson, CNM, MS

Published simultaneously in the Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2015:44(2).

epidural analgesia. Twenty minutes later when the woman’s nurse-midwife arrived, I had inserted an intravenous (IV) line, completed hospital admission paperwork, and called the anesthesiologist, who was on the way to the room. The short (and personally mortifying) end to this story was that the nurse-midwife cancelled my admission, called off the anesthesiologist, and discharged the patient home within the next 2 hours. More than a week later the woman went into spontaneous labor and had an uneventful birth. What went wrong in this clinical scenario? How were the 3 components of evidence-based practice misaligned to result in failure to apply research evidence clinically and nearly initiate epidural analgesia and labor induction inappropriately? First, I did not have the clinical expertise to accurately triage this woman for labor. The nurse-midwife started the triage process by asking questions about the woman’s contractions, not by checking her cervix. The woman’s contractions had started a few hours earlier after she spent the day at an outdoor picnic. She was very afraid of labor and rushed to the hospital soon after noticing the contractions. Next, the nursemidwife ordered an IV fluid bolus and an hour of ambulation. Later, the nurse-midwife rechecked the woman’s cervix, which was 3 cm dilated and 60% effaced with the fetus at -2 station. By this time her contractions were spaced out to every 10 to 15 minutes. Second, I did not take into account the woman’s values and preferences for the plan of care. When I rushed toward epidural analgesia, I was responding to the woman’s fears; however, I was not integrating her wishes with the bigger picture of her clinical situation and the research findings. In contrast, the nurse-midwife sat with the woman and explained that her contractions were not caused by labor but instead by dehydration. She shared with the woman that admission before strong labor could decrease the likelihood of a vaginal birth with minimal interventions. In short, the nursemidwife built a relationship with the woman that allowed her to express her fears of labor and have her questions answered. In this way, the woman’s preferences and values were incorporated in the plan for her to return home. As a result, she left the hospital better informed about her body, her labor, and her options. She was not unhappy about continuing to be pregnant, and she avoided a non-indicated induction of labor. The take-away message from this story is that excellent health care is rooted in the same components outlined as essential for evidence-based practice. Nurses were some of the first health care providers to emphasize the importance of combining empirical evidence with strong clinical skills, while keeping the background and motivation of the patient in mind.5 The hallmarks of midwifery include incorporation of scientific evidence into clinical practice and

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 c 2015 by the American College of Nurse-Midwives

APPLYING THE EVIDENCE TO PRACTICE

Arguably, the most important part of evidence-based practice (EBP) is the actual application of research evidence to clinical practice. After reviewing the first 3 steps of the 5A Model for the practitioner’s use of evidence-based information (Ask, Acquire, Appraise, Apply, and Assess) in previous editions of this column, we now move on to the step of Apply. After initially posing a clinical question in the Ask step of the 5A Model, the practitioner must then focus on acquiring and appraising research that is applicable to the clinical problem and meets quality standards in terms of research design and the generalizability of the research to the clinical problem at hand.1 In the past few columns, I discussed techniques for identifying quality research. Clinical expertise is also necessary to determine whether a research finding applies to a particular clinical situation and to implement the evidence-based recommendation.2 The third component necessary in the application of EBP is alignment with patient preferences and values.1 If the woman and family do not understand and support the plan of care, even the most well-substantiated treatment and skilled clinicians are not enough to ensure that research findings are implemented in practice. To demonstrate these concepts in action, I offer an example from my own distant past. Early in my career while working as a labor nurse, I moved to a different state and found a position in a new labor and delivery unit. Unlike the previous facility, this new unit was in a teaching hospital with a large percentage of births attended by nurse-midwives. One of my first patients was a term nulliparous woman who presented with regular contractions. On examination, her cervix was 3 cm to 4 cm dilated and 70% effaced with the fetus at -1 station and no leakage of fluid. She was distressed by her contractions and asking for epidural analgesia. At this time, research findings indicated that early admissions to the hospital in labor were associated with a greater risk of operative birth3 and that ambulation in early labor was associated with better chance of vaginal birth.4 Although I was familiar with these findings, the standard practice at my previous hospital was to admit women when they presented with regular contractions, provide epidural analgesia when requested, quickly rupture membranes artificially, and augment with oxytocin (Pitocin). I made a quick call to inform the woman’s provider of her labor and moved forward with the necessary steps to initiate

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empowerment of women as partners in health care.6 Therefore, nurses and midwives are ideally suited to resist the urge to function simply based on protocol or the culture of the clinical setting and instead to continue the tradition of care that is based on the 3 components of evidence-based practice.

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1.Duke University Medical Center, Health Sciences Library University of North Carolina. Introduction to evidence-based practice. 2013. Available from: http://guides.mclibrary.duke.edu/content. php?pid=431451&sid=3529491. 2.Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence based medicine: What it is and what it isn’t. Br Med J. 1996;312:71–2. 3.Jackson DJ. Impact of collaborative management and early admission in labor on method of delivery. J Obstet Gynecol Neonatal Nurs. 2003;32(2):147–57. 4.Albers LL, Anderson D, Cragin L, Daniels SM, Hunter KD, Teaf D. The relationship of ambulation in labor to operative delivery. J Midwifery Womens Health. 1997;42(1):4–8. 5.Nightingale F. Notes on nursing: What it is, and what it is not, 1st ed. London,: Harrison; 1860. 6.American College of Nurse Midwives. ACNM Core Competencies. 2013. Available from: http://www.midwife.org/ACNM/files/ ACNMLibraryData/UPLOADFILENAME/000000000050/Core% 20Comptencies%20Dec%202012.pdf

FROM COCHRANE DATABASE OF SYSTEMATIC REVIEWS (CDSR) ISSUES 10 & 11, 2014 New Systematic Reviews in CDSR: Women’s Health

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Minimally invasive surgical techniques versus open myomectomy for uterine fibroids Vasodilators for women undergoing fertility treatment

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Interventions for managing asthma in pregnancy Treatment for epilepsy in pregnancy: neurodevelopmental outcomes in the child High-dose versus low-dose oxytocin infusion regimens for induction of labour at term Ambroxol for women at risk of preterm birth for preventing neonatal respiratory distress syndrome Strategies of testing for syphilis during pregnancy Fetal assessment methods for improving neonatal and maternal outcomes in preterm prelabour rupture of membranes Early versus late initiation of epidural analgesia for labour Interventions for women in subsequent pregnancies following obstetric anal sphincter injury to reduce the risk of recurrent injury and associated harms Hepatitis B vaccination during pregnancy for preventing infant infection

New Systematic Reviews in CDSR: Neonatal

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Non-nutritive sucking for gastro-oesophageal reflux disease in preterm and low birth weight infants Interventions aimed at communities to inform and/or educate about early childhood vaccination

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High dose rate versus low dose rate intracavity brachytherapy for locally advanced uterine cervix cancer Immunotherapy for recurrent miscarriage Gonadotropin-releasing hormone agonist versus HCG for oocyte triggering in antagonist-assisted reproductive technology Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome

Updated Systematic Reviews in CDSR: Pregnancy and Birth

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New Systematic Reviews in CDSR: Pregnancy and Birth

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Pentoxifylline for the prevention of bronchopulmonary dysplasia in preterm infants

Antibiotic prophylaxis for third-and fourth-degree perineal tear during vaginal birth Prophylactic antibiotics for manual removal of retained placenta in vaginal birth Fetal pulse oximetry for fetal assessment in labour Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section Antibiotics for prelabour rupture of membranes at or near term Routine perineal shaving on admission in labour Different classes of antibiotics given to women routinely for preventing infection at caesarean section Interventions for preventing or reducing domestic violence against pregnant women Antibiotics for meconium-stained amniotic fluid in labour for preventing maternal and neonatal infections

FROM THE DATABASE OF ABSTRACTS AND REVIEWS OF EFFECTS (DARE) Recent Abstract Entries Assessing Quality of Systematic Reviews: Pregnancy and Birth

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Waterbirth: An Integrative analysis of peer-reviewed literature

Recent Abstract Entries Assessing Quality of Systematic Reviews: Women’s Health

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Effectiveness of mass media interventions for HIV prevention, 1986–2013 Videos to influence: A systematic review of effectiveness of video-based education in modifying health behaviors

FROM THE JOANNA BRIGGS INSTITUTE DATABASE Recent Abstract Entries Assessing Quality of Systematic Reviews: Pregnancy and Birth

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The effectiveness and maternal satisfaction of breastfeeding support for women from disadvantaged groups Influenza vaccination during pregnancy 215

Recent Abstract Entries Assessing Quality of Systematic Reviews: Neonatal

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The effectiveness of music on pain among preterm infants in the NICU

Recent Abstract Entries Assessing Quality of Systematic Reviews: Women’s Health

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Effect of yoga on sleep quality among adult cancer patients

Featured Review: Wojcieszek AM, Stock OM, & Flenady V. Antibiotics for prelabour rupture of membranes at or near term. Cochrane Database of Systematic Reviews. 2014; 10, CD001807. Premature rupture of membranes (PROM), defined as the rupture of membranes before the onset of labor, occurs in approximately 8% of term pregnancies.1 While some health care providers advocate prompt induction of labor (within 12 hours) with synthetic oxytocin or prostaglandins following PROM, others prefer to allow longer periods of time to elapse after PROM in anticipation of spontaneous contractions. Some authors found evidence that induction of labor following PROM reduced the risk of maternal infection and infant admission to the neonatal intensive care unit (NICU).2 However, the optimum time between PROM and labor induction is still an issue of debate. Some providers offer antibiotics to women experiencing PROM to decrease risk of infection, thus extending the time available for labor and birth. However, the use of antibiotics given current problems with antibiotic resistance raises concern.3 In this updated Cochrane review, the authors assessed the effects of antibiotics used prophylactically in women at or beyond 36 weeks’ gestation with PROM. The authors included 2 additional studies that more than doubled the total number of women included in the metaanalysis from the previous review (N = 2,639 in updated review). Unlike the earlier version in which the authors found a reduction in endometritis with prophylactic use of antibiotics in cases of PROM at or near term, the current authors did not find a decreased risk for endometritis with antibiotic use (relative risk [RR], 0.34; 95% confidence interval [CI], 0.05–2.31]). Also, no differences were found regarding probable early-onset neonatal sepsis (RR, 0.69; 95% CI, 0.21–2.33), definite early-onset neonatal sepsis (RR, 0.57; 95% CI, 0.08– 4.26), maternal chorioamnionitis and/or endometritis (RR, 0.48; 95% CI, 0.20–1.15), stillbirth (RR, 3.00; 95% CI, 0.61– 14.82), or perinatal mortality (RR, 1.98; 95% CI, 0.60- 6.55). Interestingly, cesarean birth increased among women receiving prophylactic antibiotics for PROM (RR, 1.33; 95% CI, 1.09–1.61) as did length of hospital stay (mean difference 0.06 days; 95% CI, 0.01–0.11) based primarily on one large study included in the meta-analysis. Authors of the updated review also completed subgroup analysis on maternal and neonatal outcomes for prophylactic antibiotic use among early labor induction (ࣘ12 hours following PROM) and late labor induction (⬎12 hours following PROM) groups. No significant differences were seen in any outcome category. However, there was a trend toward reduced probable or definite early-onset neonatal sepsis and reduced maternal infection morbidity in the late induction groups. 216

Comment: The authors of this updated Cochrane systematic review and meta-analysis found no benefit for the use of prophylactic antibiotics with PROM near or at term. Antibiotics should only be administered to women with PROM at or near term who exhibit clinical indications of infection. 1.Cammu H, Verlaenen H, Perde MP. Premature rupture of membranes at term in nulliparous women: a hazard?Obstet Gynecol. 1990;76(4):671– 4. 2.Dare MR, Middleton P, Crowther CA, Flenady VJ, Varatharaju B. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more) The Cochrane database of systematic reviews. 2006(1):CD005302. 3.American College of Obstetricians and Gynecologists. Use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2011;117(6):1472–83.

Featured Review: Widman L, Noar SM, Choukas-Bradley S, & Francis DB. Adolescent sexual health communication and condom use: A meta-analysis. Health Psychology. 2014;33(10):1113–1124. Young adults and adolescents aged between 13 and 24 years represent only one-fourth of the sexually active population, yet sexually transmitted infections (STIs) in this group account for half of all STIs each year.1 Much research during the past 20 years has focused on factors and interventions leading to improved condom use among adolescents. In this systematic review and meta-analysis, the authors synthesized evidence on sexual communication and condom use in adolescents. The review included 34 studies conducted in the United States and international locations, with a total of 15,046 participants aged between 12 and 23 years (mean age 16.77 years). Sexual communication between young males and females was included in this review. Overall, sexual communication with a partner (defined as the ability to discuss and negotiate safe sex) was positively associated with condom use (R = 0.24, P⬍.001). This moderate effect did not differ significantly by gender, age, setting, or country of study. Researchers also found that the specific content of sexual communication was important to the use of condoms. Sexual communication with a partner that was focused on condom use was more effective (r = 0.34) than sexual communication about sexual history (r = 0.15) or more general safe sexual topics (r = 0.14). This review also included results on the most effective ways to teach successful sexual communication to adolescents. Sexual communication training was significantly more likely to end in successful condom use if it was behaviorally based (r = 0.27) or focused on self-efficacy (r = 0.28) rather than focused on future intention to use condoms (r = 0.15) or fear/concern about condom use (r = 0.18). Comment: As health care providers, nurses and midwives have an important role in educating and encouraging safe sexual practices among adolescents. This review provides valuable information on sexual communication practices that can be shared with adolescents and their parents. Rather than focusing education efforts with adolescents about condom usage on fear/concerns or intention to use condoms, health care providers can more effectively serve these clients by promoting role-play communication trainings and encouraging Volume 60, No. 2, March/April 2015

adolescents to enact behavioral preparation for condom usage (eg, buy condoms, practice use of condoms). 1.Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States, 2009. Surveillance summaries. Morbidity and Mortality Weekly Report, 59(SS-5); 1–148. Available from: http://www.cdc.gov/mmwr/pdf/ss/ss5905.pdf

EVIDENCE-BASED REVIEWS FROM OTHER SOURCES Recent Evidence-Based Reviews: Women’s Health

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lomavirus infections and cervical neoplasia: systematic review of longitudinal studies. J Med Screen. 2014;21(1):38– 50. Lee JY, Lee C, Hahn S, Kim MA, Kim HS, Chung HH, et al. Prognosis of adenosquamous carcinoma compared with adenocarcinoma in uterine cervical cancer: a systematic review and meta-analysis of observational studies. Int J Gynecol Cancer. 2014;24(2):289–94. Leggett LE, Lorenzetti DL, Noseworthy T, Tiwana S, Mackean G, Clement F. Experiences and attitudes toward risk of recurrence testing in women with breast cancer: a systematic review. Breast Cancer Res Treat. 2014;144(3):457–65. Liu XO, Huang YB, Gao Y, Chen C, Yan Y, Dai HJ, et al. Association between dietary factors and breast cancer risk among Chinese females: systematic review and metaanalysis. Asian Pac J Cancer Prev. 2014;15(3):1291–8. Martins WP, Vieira CV, Teixeira DM, Barbosa MA, Dassuncao LA, Nastri CO. Ultrasound for monitoring controlled ovarian stimulation: a systematic review and metaanalysis of randomized controlled trials. Ultrasound Obstet Gynecol. 2014;43(1):25–33. Meads C, Sutton AJ, Rosenthal AN, Malysiak S, Kowalska M, Zapalska A, et al. Sentinel lymph node biopsy in vulval cancer: systematic review and meta-analysis. Br J Cancer. 2014;110(12):2837–46. Miralpeix E, Gonzalez-Comadran M, Sola I, Manau D, Carreras R, Checa MA. Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: a systematic review and meta-analysis. J Assist Reprod Genet. 2014;31(1):89–100. Nagayama A, Hayashida T, Jinno H, Takahashi M, Seki T, Matsumoto A, et al. Comparative effectiveness of neoadjuvant therapy for HER2-positive breast cancer: a network meta-analysis. J Natl Cancer Inst. 2014;106(9):1–9. Pan H, He Z, Ling L, Ding Q, Chen L, Zha X, et al. Reproductive factors and breast cancer risk among BRCA1 or BRCA2 mutation carriers: results from ten studies. Cancer Epidemiol. 2014;38(1):1–8. Phe V, Nguyen K, Roupret M, Cardot V, Parra J, ChartierKastler E. A systematic review of the treatment for female stress urinary incontinence by ACT(R) balloon placement (Uromedica, Irvine, CA, USA). World J Urol. 2014;32(2):495–505. Simmons C, Rajmohan Y, Poonja Z, Adilman R. Social media in cancer care: opportunities to improve care in locally advanced breast cancer. Current opinion in supportive and palliative care. 2014;8(1):77–82. Tavernier N, Fumery M, Peyrin-Biroulet L, Colombel JF, Gower-Rousseau C. Systematic review: fertility in nonsurgically treated inflammatory bowel disease. Aliment Pharmacol Ther. 2013;38(8):847–53. Valachis A, Nearchou AD, Lind P. Surgical management of breast cancer in BRCA-mutation carriers: a systematic review and meta-analysis. Breast Cancer Res Treat. 2014;144(3):443–55. van de Water W, Bastiaannet E, Scholten AN, Kiderlen M, de Craen AJ, Westendorp RG, et al. Breast-conserving surgery with or without radiotherapy in older breast patients with early stage breast cancer: a systematic review and meta-analysis. Ann Surg Oncol. 2014;21(3):786–94. 217

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Velez Toral M, Godoy-Izquierdo D, Padial Garcia A, Lara Moreno R, Mendoza Ladron de Guevara N, Salamanca Ballesteros A, et al. Psychosocial interventions in perimenopausal and postmenopausal women: a systematic review of randomised and non-randomised trials and noncontrolled studies. Maturitas. 2014;77(2):93–110. Verbelen H, Gebruers N, Eeckhout FM, Verlinden K, Tjalma W. Shoulder and arm morbidity in sentinel nodenegative breast cancer patients: a systematic review. Breast Cancer Res Treat. 2014;144(1):21–31. Vitek WS, Shayne M, Hoeger K, Han Y, Messing S, Fung C. Gonadotropin-releasing hormone agonists for the preservation of ovarian function among women with breast cancer who did not use tamoxifen after chemotherapy: a systematic review and meta-analysis. Fertil Steril. 2014;102(3):808.e1–815.e1. Wen KY, Fang CY, Ma GX. Breast cancer experience and survivorship among Asian Americans: a systematic review. J Cancer Surviv. 2014;8(1):94–107. Widman L, Noar SM, Choukas-Bradley S, Francis DB. Adolescent sexual health communication and condom use: a meta-analysis. Health Psychol. 2014;33(10):1113– 24. Worsley R, Bell R, Kulkarni J, Davis SR. The association between vasomotor symptoms and depression during perimenopause: a systematic review. Maturitas 2014;77(2):111–7. Wyatt KD, Anderson RT, Creedon D, Montori VM, Bachman J, Erwin P, et al. Women’s values in contraceptive choice: a systematic review of relevant attributes included in decision aids. BMC Womens Health. 2014;14(1):28. Zhang H, Tao X, Wu J. Association of homocysteine, vitamin B12, and folate with bone mineral density in postmenopausal women: a meta-analysis. Arch Gynecol Obstet. 2014;289(5):1003–9.

Recent Evidence-Based Reviews: Pregnancy & Birth

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Aune D, Norat T, Romundstad P, Vatten LJ. Breastfeeding and the maternal risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis. 2014;24(2):107–15. Baldacchino A, Arbuckle K, Petrie DJ, McCowan C. Neurobehavioral consequences of chronic intrauterine opioid exposure in infants and preschool children: a systematic review and meta-analysis. BMC Psychiatr. 2014;14:104. Benjamin DR, van de Water AT, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy. 2014;100(1):1–8. Brite J, Shiroma EJ, Bowers K, Yeung E, Laughon SK, Grewal JG, et al. Height and the risk of gestational diabetes: variations by race/ethnicity. Diabet Med. 2014;31(3):332– 40. Cecchino GN, Araujo Junior E, Elito Junior J. Methotrexate for ectopic pregnancy: when and how. Arch Gynecol Obstet. 2014;290(3):417–23. Fan W, Li S, Huang Z, Chen Q. Relationship between HLAG polymorphism and susceptibility to recurrent miscar-

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riage: a meta-analysis of non-family-based studies. J Assist Reprod Genet. 2014;31(2):173–84. Flak AL, Su S, Bertrand J, Denny CH, Kesmodel US, Cogswell ME. The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: a meta-analysis. Alcohol Clin Exp Res. 2014;38(1):214–26. Gonzalez R, Hellgren U, Greenwood B, Menendez C. Mefloquine safety and tolerability in pregnancy: a systematic literature review. Malar J. 2014;13:75. Hartling L, Dryden DM, Guthrie A, Muise M, Vandermeer B, Donovan L. Diagnostic thresholds for gestational diabetes and their impact on pregnancy outcomes: a systematic review. Diabet Med. 2014;31(3):319–31. Kebed KY, Bishu K, Al Adham RI, Baddour LM, Connolly HM, Sohail MR, et al. Pregnancy and postpartum infective endocarditis: a systematic review. Mayo Clin Proc. 2014;89(8):1143–52. Kong D, Liu H, Wei S, Wang Y, Hu A, Han W, et al. A meta-analysis of the association between gestational diabetes mellitus and chronic hepatitis B infection during pregnancy. BMC Res Notes. 2014;7:139. Li J, Chen Y, Wu H, Li L. Apolipoprotein E (Apo E) gene polymorphisms and recurrent pregnancy loss: a metaanalysis. J Assist Reprod Genet. 2014;31(2):139–48. Marom R, Lubetzky R, Mimouni FB, Ovental A, Mandel D, Cohen S. Secular trends in impact factor of breastfeeding research publications over a 20-year period. Breastfeed Med. 2014;9(2):98–100. Money D, Tulloch K, Boucoiran I, Caddy S, Yudin MH, Allen V, et al. Guidelines for the care of pregnant women living with HIV and interventions to reduce perinatal transmission: executive summary. J Obstet Gynaecol Can. 2014;36(8):721–51. Pedersen M, Stayner L, Slama R, Sorensen M, Figueras F, Nieuwenhuijsen MJ, et al. Ambient air pollution and pregnancy-induced hypertensive disorders: a systematic review and meta-analysis. Hypertension. 2014;64(3):494– 500. Su DF, Wang XY. Metformin vs insulin in the management of gestational diabetes: a systematic review and metaanalysis. Diabetes Res Clin Pract. 2014;104(3):353–7. Wittkowski A, Gardner PL, Bunton P, Edge D. Culturally determined risk factors for postnatal depression in SubSaharan Africa: a mixed method systematic review. J Affect Disord. 2014;163:115–24. Xu G, Jing J, Bowers K, Liu B, Bao W. Maternal diabetes and the risk of autism spectrum disorders in the offspring: a systematic review and meta-analysis. J Autism Dev Disord. 2014;44(4):766–75. Xu Y, Shen S, Sun L, Yang H, Jin B, Cao X. Metabolic syndrome risk after gestational diabetes: a systematic review and meta-analysis. PLoS One. 2014;9(1):e87863. Yang B, Fan S, Zhi X, Li Y, Liu Y, Wang D, et al. Associations of MTHFR gene polymorphisms with hypertension and hypertension in pregnancy: a meta-analysis from 114 studies with 15411 cases and 21970 controls. PLoS One. 2014;9(2):e87497. Yu RX, Yin Y, Wang GQ, Chen SC, Zheng BJ, Dai XQ, et al. Worldwide susceptibility rates of Neisseria gonorrhoeae Volume 60, No. 2, March/April 2015

isolates to cefixime and cefpodoxime: a systematic review and meta-analysis. PLoS One. 2014;9(1):e87849. Recent Evidence-Based Reviews: Neonatal

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Akyurekli C, Chan JY, Elmoazzen H, Tay J, Allan DS. Impact of ethnicity on human umbilical cord blood banking: a systematic review. Transfusion (Paris). 2014;54(8):2122–7. Araujo de Franca GV, Restrepo-Mendez MC, Loret de Mola C, Victora CG. Size at birth and abdominal adiposity in adults: a systematic review and meta-analysis. Obes Rev. 2014;15(2):77–91. Cassina M, Dona M, Di Gianantonio E, Litta P, Clementi M. First-trimester exposure to metformin and risk of birth defects: a systematic review and meta-analysis. Hum Reprod Update. 2014;20(5):656–69. Khalil A, Suff N, Thilaganathan B, Hurrell A, Cooper D, Carvalho JS. Brain abnormalities and neurodevelopmental delay in congenital heart disease: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2014;43(1):14–24. Lange S, Shield K, Koren G, Rehm J, Popova S. A comparison of the prevalence of prenatal alcohol exposure obtained via maternal self-reports versus meconium testing: a systematic literature review and meta-analysis. BMC Pregnancy Childbirth. 2014;14:127. Luo L, Chen D, Qu Y, Wu J, Li X, Mu D. Association between hypoxia and perinatal arterial ischemic stroke: a meta-analysis. PLoS One. 2014;9(2):e90106. Maitra K, Park HY, Eggenberger J, Matthiessen A, Knight E, Ng B. Difficulty in mental, neuromusculoskeletal, and movement-related school functions associated with low birthweight or preterm birth: a meta-analysis. Am J Occup Ther. 2014;68(2):140–8. Moreira RS, Magalhaes LC, Alves CR. Effect of preterm birth on motor development, behavior, and school performance of school-age children: a systematic review. J Pediatr (Rio J). 2014;90(2):119–34.

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AUTHOR

Nicole S. Carlson, CNM, MS, is a doctoral candidate in the College of Nursing, University of Colorado Denver, Denver, CO.

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April 2015.

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