Concordance Among National and International Obstetric Guidelines [ID 1447]

INTRODUCTION: Recommendations for managing obstetric conditions vary across societies due to lack of strong evidence and differences in culture. This study both compares and, uniquely, quantifies the concordance of recommendations of obstetric guidelines between the United States and five other countries. METHODS: Five countries (Canada, the United Kingdom, France, Mexico, and Spain) were selected a priori for comparison. All obstetrics guidelines published by the American College of Obstetricians and Gynecologists (ACOG) from 2017 to 2023 were reviewed. Topics with published guidelines in all six countries were selected. American College of Obstetricians and Gynecologists recommendations were matched with corresponding recommendations from the five countries’ guidelines. Recommendations were categorized by guideline topic and area of care. Concordance scores for each pair of recommendations were provided by reviewers using a 0–10 scale (0=completely different; 10=exactly the same). Scores were compared by country, topic, and subtopic using the Kruskal–Wallis test with correction for multiple comparisons. RESULTS: We identified 70 ACOG guidelines, of which four topics (preterm birth, multifetal gestation, hypertensive disorders of pregnancy [HDP], and postpartum hemorrhage [PPH]) were addressed in the five selected countries’ guidelines. Concordance scores for each topic were significantly different among the countries ( P <.0001). For HDP guidelines, concordance scores were significantly higher ( P <.0125) for ACOG-Spain and ACOG-Mexico compared to ACOG-UK and ACOG-Canada, with similar trends in other topics. The PPH guidelines achieved the highest scores in all countries. CONCLUSIONS/IMPLICATIONS: This study provides a model for guideline concordance quantification, rather than qualitative comparison. Recommendation concordance was greater between ACOG and Spanish-speaking societies than ACOG-English- and French-speaking societies.