WHO recommendations on antenatal care for a positive pregnancy experience

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<strong>WHO</strong> headquarters (Geneva, Switzerland) Emma Allanson Consultant Department of Reproductive Health and Research Maternal and Perinatal Health & Preventing Unsafe Abortion Team External reviewers Yacouba Yaro Director General Center for Studies, Research and Training for Economic and Social Development (CERFODES) Ouagadougou, Burkina Faso <strong>WHO</strong> <strong>recommendations</strong> on antenatal care for a positive pregnancy experience Maurice Bucagu Medical Officer, Maternal Health Services Department of Maternal, Newborn, Child and Adolescent Health Policy, Planning and Programme Unit Sarah de Masi Technical Officer Department of Reproductive Health and Research Maternal and Perinatal Health & Preventing Unsafe Abortion Team Pura Rayco-Solon Epidemiologist Department Nutrition for Health and Development Evidence and Programme Guidance Team Lisa Rogers Technical Officer Department Nutrition for Health and Development Evidence and Programme Guidance Team Joshua Vogel Technical Officer Department of Reproductive Health and Research Maternal and Perinatal Health & Preventing Unsafe Abortion Team Zita Weise Technical Officer Department Nutrition for Health and Development Evidence and Programme Guidance Team Tamar Kabakian Associate Professor Health Promotion and Community Health Department Faculty of Health Sciences American University of Beirut Beirut, Lebanon Petr Velebil Obstetrician Perinatal Centre of the Institute for the Care of Mother and Child Prague, Czech Republic Rodolfo Gomez Reproductive Health Advisor Latin American Center for Perinatology, Women and Reproductive Health (CLAP/WR) Montevideo, Uruguay 140
Annex 2: Other <strong>WHO</strong> guidelines with <strong>recommendations</strong> relevant to routine ANC <strong>WHO</strong> guideline title Year of publication <strong>WHO</strong> department responsible Approach 1. Increasing access to health workers in remote and rural areas through improved retention: global policy <strong>recommendations</strong> 2010 Various <strong>WHO</strong> departments and regional representatives. Recommendation relevant to ANC was adapted for, and integrated into, the ANC guideline. 2. Guideline: vitamin A supplementation in pregnant women 2011 Department of Nutrition for Health and Development (NHD) Department of Reproductive Health and Research (RHR) Department of Maternal, Newborn, Child and Adolescent Health (MCA) New recommendation in the ANC guideline supersedes the recommendation in this 2011 guideline. 3. <strong>WHO</strong> <strong>recommendations</strong> for prevention and treatment of pre-eclampsia and eclampsia 2011 RHR, MCA Cross-checked for consistency 4. Preventing early pregnancy and poor reproductive outcomes 2011 MCA, RHR, Department of Child and Adolescent Health (CAH), Making Pregnancy Safer Referenced 5. <strong>WHO</strong> <strong>recommendations</strong>: optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting (OptimizeMNH) 2012 RHR Recommendation relevant to ANC was adapted for, and integrated into, the ANC guideline. 6. Guideline: vitamin D supplementation in pregnant women 2012 NHD, RHR, MCA New recommendation in the ANC guideline supersedes the recommendation in this 2012 guideline. 7. Guideline: intermittent iron and folic acid supplementation in non-anaemic pregnant women 2012 NHD, RHR, MCA New recommendation in the ANC guideline supersedes the recommendation in this 2012 guideline. 8. Guideline: daily iron and folic acid supplementation in pregnant women 2012 NHD, RHR, MCA New recommendation in the ANC guideline supersedes the recommendation in this 2012 guideline. 9. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy 2013 Chronic Diseases Prevention and Management, RHR Recommendation relevant to ANC was integrated into the ANC guideline. 10. Responding to intimate partner violence and sexual violence against women 2013 RHR Cross-checked for consistency 11. Guideline: calcium supplementation in pregnant women 2013 NHD New recommendation in the ANC guideline supersedes the recommendation in this 2013 guideline. Annex 2: Other <strong>WHO</strong> guidelines 141
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« To achieve the Every Woman Every
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Funding was provided for this guide
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Evaluation (GRADE) and Confidence i
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Zinc supplements Multiple micronutr
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Ultrasound scan Doppler ultrasound
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Task shifting components of antenat
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expect from ANC is to have a “pos
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2. Methods WHO <st
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a list of ANC outcomes was prioriti
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content experts among the GDG membe
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• nFeasibility: Feasibility is in
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are indicated by a footnote in the
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A. Nutritional interventions <stron
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A.1.2: Nutrition education on energ
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A.1.3: Energy and protein dietary s
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A.1.4: High-protein supplements REC
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Summary of evidence and considerati
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Equity Effective interventions to i
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A.7: Vitamin B6 (pyridoxine) supple
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only a quarter of the planned sampl
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A.10: Restricting caffeine intake R
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B. Maternal and fetal assessment B.
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to produce results than urine dipst
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B.1.4: Gestational diabetes mellitu
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B.1.6: Substance use RECOMMENDATION
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on screening, please refer to the 2
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Women’s values A scoping review o
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B.2.2: Symphysis-fundal height (SFH
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B.2.4: Ultrasound scan RECOMMENDATI
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are willing to be screened and test
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Women’s values A scoping review o
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C.4: Preventive anthelminthic treat
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C.5: Tetanus toxoid vaccination REC
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C.6: Intermittent preventive treatm
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D. Interventions for common physiol
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Values See “Women’s values” a
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D.4: Interventions for low back and
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Acceptability Qualitative evidence
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Additional considerations • nComp
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Senegal, Sri Lanka, Yemen and Zambi
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WHO recommendations on antenatal care for a positive pregnancy experience

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