185378 Nuchal translucency and Down syndrome prenatal screening methods provided by OB-GYN physicians to expectant mothers in Kentucky

Wednesday, October 29, 2008

Jennifer M. Howard, MPH , School of Public Health and Information Sciences, University of Louisville, Louisville, KY
Lydia G. Watson, BA , Bellarmine University, Louisville, KY
Kristina Zierold, PhD, MS , Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences, Louisville, KY
Leah Y. Carreon, MD, MSc , Leatherman Spine Center, Louisville, KY
Background:

In January 2007, the American College of Obstetrics and Gynecology (ACOG) recommended universal prenatal screening for Down syndrome during the first trimester of pregnancy regardless of maternal age or risk. ACOG guidelines suggest the use of nuchal translucency (NT) in addition to traditional maternal serum screenings to more accurately estimate the risk of Down syndrome. While the ACOG recommendations were made over a year ago, little is known about the prevalence of NT and the amount of education patients are given regarding screening.

Methods:

A questionnaire was utilized to survey 173 OB-GYN physicians in nine Kentucky counties on the types of prenatal Down syndrome screening available in their offices. Eligible physicians were found using the Kentucky Board of Medical Licensure and Jefferson County Medical Society registries, as well as local phone books. Inactive physicians older than 65 years and OB-GYN residents were excluded. The questionnaire was delivered in February 2008.

Data from the questionnaires will be analyzed using SAS. Frequencies and cross-tabulations will be completed and percentages reported.

Results:

Specific questions to be answered by this study include: What percentages of clinicians are following the NT screening guidelines presented by the ACOG? When do clinicians and their staff provide education to their patients regarding Down syndrome: before or after screening? How much time is spent educating patients on NT screening and Down syndrome?

Implications:

Studies suggest that expectant parents continue to receive out-dated and insufficient information on Down syndrome prenatal screening and diagnosis. With the recent ACOG guidelines recommending universal prenatal screening, it is imperative to understand the amount of education provided by OB-GYN physicians to patients on NT and Down syndrome. These results will provide us with a better understanding of the methods and amount of education made available and allow for the development of additional materials.

Learning Objectives:
1. Determine the percentage of OB-GYN physicians in Jefferson, Bullitt, Oldham, Shelby, Spencer, Henry, Trimble, Hardin, and Nelson counties in Kentucky offering nuchal translucency screenings. 2. Assess whether OB-GYN physicians are willing to distribute an educational pamphlet on Down syndrome and nuchal translucency screenings to expectant mothers. 3. Evaluate an educational pamphlet on Down syndrome and nuchal translucency screenings using focus groups consisting of local OB-GYN physicians and mothers of children with Down syndrome.

Keywords: Prenatal Interventions, Birth Defects

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: This is my practicum project that is required for me to complete my MPH degree in May 2008.
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.

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