Please use this identifier to cite or link to this item: https://ir.swu.ac.th/jspui/handle/123456789/13666
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dc.contributor.authorPhupong V.
dc.contributor.authorHanprasertpong T.
dc.date.accessioned2021-04-05T03:25:30Z-
dc.date.available2021-04-05T03:25:30Z-
dc.date.issued2015
dc.identifier.issn1469493X
dc.identifier.other2-s2.0-84950116221
dc.identifier.urihttps://ir.swu.ac.th/jspui/handle/123456789/13666-
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-84950116221&doi=10.1002%2f14651858.CD011379.pub2&partnerID=40&md5=0d60ce94846255bb8822a7eed428af55
dc.description.abstractBackground: Heartburn is one of the most common gastrointestinal symptoms in pregnant women. It can occur in all trimesters of pregnancy. The symptoms of heartburn in pregnancy may be frequent, severe and distressing, but serious complications are rare. Many interventions have been used for the treatment of heartburn in pregnancy. These interventions include advice on diet, lifestyle modification and medications. However, there has been no evidence-based recommendation for the treatment of heartburn in pregnancy. Objectives: To assess the effects of interventions for relieving heartburn in pregnancy. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2015), ClinicalTrials.gov (2 March 2015), Asian & Oceanic Congress of Obstetrics & Gynaecology (AOCOG) conference proceedings (20-23 October 2013, Centara Grand & Bangkok Convention Centre, Bangkok, Thailand), and reference lists of retrieved studies. Selection criteria: Randomised controlled trials (RCTs) and quasi-RCTS of interventions for heartburn in pregnancy compared with another intervention, or placebo, or no intervention. Cluster-RCTs would have been eligible for inclusion but none were identified. We excluded studies available as abstracts only and those using a cross-over design. Interventions could include advice on diet, lifestyle modification and medications (such as antacids, sucralfate, histamine 2-receptor antagonists, promotility drugs and proton pump inhibitors (PPIs)). Data collection and analysis: Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Main results: We included nine RCTs involving 725 women. However, five trials did not contribute data. Four trials involving 358 women contributed data. Trials were generally at mixed risk of bias. We only identified data for three comparisons: pharmaceutical treatment versus placebo or no treatment; acupuncture versus no treatment and pharmacological intervention versus advice on dietary and lifestyle changes. Pharmaceutical treatment compared with placebo or no treatment Two trials evaluated any pharmaceutical treatment compared with placebo or no treatment. One trial examined a treatment rarely used nowadays (intramuscular prostigmine 0.5 mg versus placebo). One trial evaluated the effect of magnesium and aluminium hydroxide plus simethicone liquid and tablet compared with placebo. For the primary outcome of this review (relief of heartburn), women who received pharmaceutical treatment reported complete heartburn relief more often than women receiving no treatment or placebo (risk ratio (RR) 1.85, 95% confidence interval (CI) 1.36 to 2.50 in two RCTs of 256 women, I2 = 0%, moderate-quality evidence). Data on partial relief of heartburn were heterogenous and showed no clear difference (average RR 1.35, 95% CI 0.38 to 4.76 in two RCTs of 256 women, very low-quality evidence). In terms of secondary outcomes, there was no clear difference in the rate of side effects between the pharmaceutical treatment group and the placebo/no treatment group (RR 0.63, 95% CI 0.21 to 1.89 in two RCTs of 256 women, very low-quality evidence). Pharmacological intervention versus advice on dietary and lifestyle choices One study compared 1 g of sucralfate with advice on dietary and lifestyle choices in treating heartburn. More women in the sucralfate group experienced complete relief of heartburn compared to women who received advice on diet and lifestyle choices (RR 2.41, 95% CI 1.42 to 4.07; participants = 65; studies = one). The only secondary outcome of interest addressed by this trial was side effects. The evidence was not clear on intervention side effects rate between the two groups (RR 1.74, 95% CI 0.07 to 41.21; participants = 66; studies = one). There was only one instance of side effects in the pharmacological group. Acupuncture compared with no treatment One trial evaluated acupuncture compared with no treatment but did not report data relating to this review's primary outcome (relief of heartburn). In terms of secondary outcomes, there was no difference in the rate of side effects between women who had acupuncture and women who had no treatment (RR 2.43, 95% CI 0.11 to 55.89 in one RCT of 36 women). With regard to quality of life, women who had acupuncture reported improved ability to sleep (RR 2.80, 95% CI 1.14 to 6.86) and eat (RR 2.40, 95% CI 1.11 to 5.18 in one RCT of 36 women). The following secondary outcomes were not reported upon in any of the trials included in the review: miscarriage, preterm labour, maternal satisfaction, fetal anomalies, intrauterine growth restriction, low birthweight. Authors' conclusions: There are no large-scale RCTs to assess heartburn relief in pregnancy. This review of nine small studies (which involved data from only four small studies) indicates that there are limited data suggesting that heartburn in pregnancy could be completely relieved by pharmaceutical treatment. Three outcomes were assessed and assigned a quality rating using the GRADE methods. Evidence from two trials for the outcome of complete relief of heartburn was assessed as of moderate quality. Evidence for the outcomes of partial heartburn relief and side effects was graded to be of very low quality. Downgrading decisions were based in part on the small size of the trials and on heterogenous and imprecise results. There are insufficient data to assess acupuncture versus no treatment and no data to assess other comparisons (miscarriage, preterm labour, maternal satisfaction, fetal anomalies, intrauterine growth restriction, low birthweight). Further RCTs are needed to fully evaluate the effectiveness of interventions for heartburn in pregnancy. Future research should also address other medications such as histamine 2-receptor antagonists, promotility drugs, proton pump inhibitors, and a raft-forming alginate reflux suppressant in treatment of heartburn in pregnancy. More research is needed on acupuncture and other complimentary therapies as treatments for heartburn in pregnancy. Future research should also evaluate any adverse outcomes, maternal satisfaction with treatment and measure pregnant women's quality of life in relation to the intervention. © 2015 The Cochrane Collaboration.
dc.subjectaluminum hydroxide
dc.subjectantacid agent
dc.subjectgastrointestinal agent
dc.subjecthistamine H2 receptor antagonist
dc.subjectmagnesium
dc.subjectneostigmine
dc.subjectplacebo
dc.subjectpromotility drug
dc.subjectproton pump inhibitor
dc.subjectsimethicone
dc.subjectsucralfate
dc.subjectunclassified drug
dc.subjectaluminum hydroxide
dc.subjectmagnesium hydroxide
dc.subjectneostigmine
dc.subjectacupuncture
dc.subjectclinical outcome
dc.subjectcluster analysis
dc.subjectdiet therapy
dc.subjectevidence based medicine
dc.subjectfetus malformation
dc.subjectheartburn
dc.subjecthuman
dc.subjectintrauterine growth retardation
dc.subjectlifestyle modification
dc.subjectlow birth weight
dc.subjectmeta analysis
dc.subjectoutcome assessment
dc.subjectpatient satisfaction
dc.subjectpregnancy
dc.subjectpregnant woman
dc.subjectpremature labor
dc.subjectpriority journal
dc.subjectquality of life
dc.subjectrandomized controlled trial (topic)
dc.subjectReview
dc.subjectsleep parameters
dc.subjectspontaneous abortion
dc.subjectsystematic review
dc.subjecttreatment response
dc.subjectacupuncture
dc.subjectadult
dc.subjectfemale
dc.subjectheartburn
dc.subjectpregnancy
dc.subjectPregnancy Complications
dc.subjectAcupuncture Therapy
dc.subjectAdult
dc.subjectAluminum Hydroxide
dc.subjectAntacids
dc.subjectFemale
dc.subjectHeartburn
dc.subjectHumans
dc.subjectMagnesium Hydroxide
dc.subjectNeostigmine
dc.subjectPregnancy
dc.subjectPregnancy Complications
dc.subjectRandomized Controlled Trials as Topic
dc.subjectSucralfate
dc.titleInterventions for heartburn in pregnancy
dc.typeReview
dc.rights.holderScopus
dc.identifier.bibliograpycitationCochrane Database of Systematic Reviews. Vol 2015, No.9 (2015), p.-
dc.identifier.doi10.1002/14651858.CD011379.pub2
Appears in Collections:Scopus 1983-2021

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