The National COVID-19 Clinical Evidence Taskforce: pregnancy and perinatal guidelines

Area of Science:

• Maternal-fetal medicine
• Infectious disease epidemiology
• Clinical evidence synthesis

Background:

• Pregnant women exhibit increased susceptibility to severe outcomes from coronavirus disease 2019 (COVID-19).
• The COVID-19 pandemic necessitated the rapid development and dissemination of evidence-based clinical guidelines.
• A dedicated Pregnancy and Perinatal Care Panel was established to prioritize and guide care for this vulnerable population.

Purpose of the Study:

• To establish and implement a rapid, living guidelines approach for managing COVID-19 in pregnant and breastfeeding women.
• To provide timely, evidence-based recommendations for Australian maternity care providers.
• To ensure the inclusion of specific considerations for pregnancy and the perinatal period in national COVID-19 clinical guidance.

Main Methods:

• The National COVID-19 Clinical Evidence Taskforce convened a specialized panel for pregnancy and perinatal care.
• Systematic reviews of emerging evidence were conducted to inform guideline development.
• Recommendations were continuously updated to reflect the latest scientific findings and clinical data.

Main Results:

• As of May 2022, seven recommendations addressed standard maternity care practices, including mode of birth and breastfeeding.
• Eleven recommendations focused on COVID-19-specific treatments, with conditional support for remdesivir, tocilizumab, and sotrovimab.
• Recommendations advised against the use of hydroxychloroquine and ivermectin for COVID-19 treatment.

Conclusions:

• The National COVID-19 Clinical Evidence Taskforce successfully provided critical infrastructure for maternity care during the pandemic.
• A rapid, living guidelines model proved feasible and acceptable for managing evolving clinical evidence.
• The Taskforce's approach ensured that pregnant and breastfeeding women received up-to-date, evidence-based care recommendations.