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Updated clinical practice guidelines on pregnancy care

Caroline SE Homer, Jeremy Oats, Philippa Middleton, Jenny Ramson and Samantha Diplock
Med J Aust 2018; 209 (9): 409-412. || doi: 10.5694/mja18.00286
Published online: 5 November 2018

Abstract

Introduction: The clinical practice guidelines on pregnancy care have been developed to provide reliable and standardised guidance for health professionals providing antenatal care in Australia. They were originally released as the Clinical Practice Guidelines: Antenatal Care in two separate editions (modules 1 and 2) in 2012 and 2014. These modules have now been combined and updated to form a single set of consolidated guidelines that were publicly released in February 2018 as the Clinical Practice Guidelines: Pregnancy Care. Eleven topics have been updated and new guidance on substance use in pregnancy has been added.

Main recommendations: The updated guidelines include the following key changes to practice:

  • recommend routine testing for hepatitis C at the first antenatal visit;
  • recommend against routine testing for vitamin D status in the absence of a specific indication;
  • recommend discussing weight change, diet and physical activity with all pregnant women; and
  • recommend offering pregnant women the opportunity to be weighed at every antenatal visit and encouraging women to self-monitor weight gain.

Changes in management as a result of the guidelines: The guidelines will enable pregnant women diagnosed with hepatitis C to be identified and thus avoid invasive procedures that increase the risk of mother-to-baby transmission. Women can be treated postpartum, reducing the risk of liver disease and removing the risk of perinatal infection for subsequent pregnancies. Routine testing of all pregnant women for vitamin D status and subsequent vitamin D supplementation is not supported by evidence and should cease as the benefits and harms of vitamin D supplementation remain unclear. The recommendation for health professionals to provide advice to pregnant women about weight, diet and physical activity, and the opportunity to be weighed will help women to make changes leading to better health outcomes for themselves and their babies.

  • Caroline SE Homer1,2
  • Jeremy Oats3
  • Philippa Middleton4
  • Jenny Ramson5
  • Samantha Diplock6

  • 1 Centre for Midwifery, Child and Family Health, UTS Sydney, Sydney, NSW
  • 2 Burnet Institute, Melbourne, VIC
  • 3 Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
  • 4 Robinson Research Institute, University of Adelaide, Adelaide, SA
  • 5 Ampersand Health Science Writing, Tanja, NSW
  • 6 Department of Health, Canberra, ACT

Correspondence: caroline.homer@uts.edu.au

Acknowledgements: 

The review of the guidelines was jointly funded by the Australian Government and the states and territories. The review was project managed by the Australian Government Department of Health. The authors acknowledge the engagement and support of the Australian College of Midwives, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, the Royal Australian College of General Practitioners and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. EWG members who have supported the review of the guidelines: Professor Jeremy Oats, University of Melbourne (co-chair); Professor Caroline Homer, University of Technology Sydney and the Australian College of Midwives (co-chair); Associate Professor Philippa Middleton, South Australian Health and Medical Research Institute Adelaide; Dr Martin Byrne, Royal Australian College of General Practitioners; Ann Catchlove, consumer representative; Lisa Clements, migrant and refugee women representative; Dr Anthony Hobbs, Commonwealth Deputy Chief Medical Officer; Tracy Martin, WA Health; Professor Sue McDonald, La Trobe University; Dr Sarah Jane McEwan, Western Australian Country Hedland Service; Professor Michael Permezel, Royal Australian College of Obstetricians and Gynaecologists; Adjunct Professor Debra Thoms, Commonwealth Chief Nursing and Midwifery Officer; Louis Young, Department of Health (Secretariat); Samantha Diplock, Department of Health (Secretariat); Anita Soar, Department of Health (Secretariat); and Jenny Ramson, Ampersand Health Science Writing (technical writer).

Competing interests:

No relevant disclosures.

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