180092 Pregnant patients and perinatal providers: Are we on the same page regarding preterm birth?

Monday, October 27, 2008

F.L. Mara Burney, MPH , Office of the Medical Director, March of Dimes, White Plains, NY
Karla Damus, RN, MSPH, PhD , Office of the Medical Director, March of Dimes, White Plains, NY
Julie Solomon, PhD , J. Solomon Consulting, LLC, Mountain View, CA
LeAnn Langston, RN , Center for Women's Health, Trover Clinic, Madisonville, KY
Jennifer Sparks, RN, MSN , King's Daughters Medical Center, Ashland, KY
Nancy Jennings, RN, MSN , Bluegrass High Risk Clinic, University of Kentucky, Lexington, KY
Diane M. Ashton, MD, MPH , Office of the Medical Director, March of Dimes, White Plains, NY
Despite decades of research and programs to reduce preterm birth (PTB), rates reached an all time US high in 2005 of 12.7% and 15.2% in Kentucky. Understanding the PTB-related knowledge, attitudes, and behaviors (KAB) of both pregnant women and their perinatal providers is key to implementing prematurity prevention programs like Healthy Babies are Worth the Wait (HBWW). Research was conducted to determine areas of concordance and discordance in six Kentucky communities.

Methods: During January-May 2007, baseline surveys were completed by prenatal patients and their providers in six HBWW sites. KAB data were collected about: PTB, late PTB, modifiable risks factors, newborn/maternal complications, progesterone to prevent PTB, elective inductions, and cesarean delivery on maternal request.

Results: 1066 consumer and 135 provider surveys were analyzed. Concordance was observed for causes of PTB: providers and patients ranked high risk behaviors (e.g. smoking, illicit drug use) as major contributors. A high proportion of both groups were unsure about about the use of progesterone. Major discordance was reported for late PTB as 91% of providers were very/somewhat concerned about increasing rates yet only half of pregnant women felt it was serious. Gaps between provider attitudes and patient behaviors were also observed; 95% of providers felt that smoking cessation during pregnancy was “very important”, but nearly a quarter of their pregnant patients continued to smoke.

Conclusions: Perinatal providers must be informed about the PTB-related KAB of the women they in order to enhance interventions to prevent PTB. Continuing education of results from local, timely surveys of patients and providers is recommended to help enhance management and prevent preventable PTB.

Learning Objectives:
1. Discuss responses of pregnant women and perinatal providers regarding modifiable risk factors for preterm birth. 2. Identify significant areas of concordance and discordance in knowledge, attitudes, and behaviors about preterm birth between patients and providers. 3. Recommend appropriate courses of provider training and patient education based on results.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I developed the survey instrument, conducted and analyzed the findings, and am trained in public health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.