Document Detail


Attitudes and practices regarding late preterm birth among American obstetrician-gynecologists.
MedLine Citation:
PMID:  23350861     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Late preterm birth (LPTB) accounts for most preterm births and has been increasing, associated with increases in cesarean sections and inductions at this gestational age.
METHODS: A self-administered survey, consisting of questions about opinions, knowledge, and practices regarding LPTB, was mailed to 1232 American College of Obstetricians and Gynecologists (ACOG) Fellows and Junior Fellows in Practice in May-July 2010.
RESULTS: Surveys were returned by 520 practicing obstetricians. Two thirds of respondents correctly defined LPTB (34-36 weeks completed gestation). Most responding physicians (87%) were aware of the evidence regarding morbidity and mortality of infants born at 34-36 weeks; 81% considered such evidence sufficient to make a clinical judgment. Although 84% were concerned about long-term health problems in these infants, many disagreed that LPTB infants were at increased risk of long-term neurodevelopmental outcomes. Most agreed that the increase in LPTB in the United States is due to increasing rates and complications of multifetal pregnancies and maternal disorders. Almost all responding physicians agreed that certain clinical indications (e.g., severe preeclampsia, placental abruption, premature rupture of the membranes [PROM]) were appropriate reasons for early delivery, and most disagreed with delivering late preterm infants for logistical reasons or convenience. Half of responding physicians reported that concerns about malpractice risks contribute to their decision to induce labor or perform a cesarean section at 34-36 weeks.
CONCLUSIONS: Many obstetricians underestimate long-term neurodevelopmental outcomes among infants born late preterm and may have a lower threshold to deliver some infants late preterm for indications that are not evidence based. Additional educational efforts regarding LPTB are needed.
Authors:
Michael L Power; Zsakeba Henderson; Julia E Behler; Jay Schulkin
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2013-01-25
Journal Detail:
Title:  Journal of women's health (2002)     Volume:  22     ISSN:  1931-843X     ISO Abbreviation:  J Womens Health (Larchmt)     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-12     Completed Date:  2013-05-22     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  101159262     Medline TA:  J Womens Health (Larchmt)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  167-72     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Attitude of Health Personnel*
Delivery, Obstetric*
Female
Gestational Age
Gynecology / statistics & numerical data*
Humans
Infant, Newborn
Male
Obstetrics / statistics & numerical data*
Physician's Practice Patterns / statistics & numerical data*
Pregnancy
Pregnancy Outcome
Premature Birth*
Risk Factors
Time Factors
United States
Grant Support
ID/Acronym/Agency:
R60 MC05674//PHS HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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