Maternal serum screening in Newfoundland and Labrador: do attitude and knowledge affect physicians' practice?

Area of Science:

• Medical Genetics
• Obstetrics and Gynecology
• Family Medicine

Background:

• Maternal serum screening (MSS) is a key component of prenatal care, aiding in the detection of fetal aneuploidies.
• Understanding family physicians' current practices, attitudes, and knowledge regarding MSS is crucial for optimizing its implementation and patient counseling.
• Variations in MSS offering practices among physicians may impact equitable access to prenatal screening services.

Purpose of the Study:

• To assess the current practices, attitudes, and knowledge of family physicians concerning maternal serum screening (MSS) in Newfoundland and Labrador.
• To compare the characteristics of physicians who offer MSS universally versus those who offer it selectively or not at all.
• To identify factors influencing physicians' decisions regarding MSS provision.

Main Methods:

• A cross-sectional mailed survey was conducted among 182 family physicians providing prenatal care in Newfoundland and Labrador.
• Data collected included sociodemographic characteristics, practice patterns regarding MSS, attitudes toward MSS, and knowledge about its detection rates and optimal gestational timing.
• Physicians were categorized based on whether they offered MSS to all, some, or none of their pregnant patients.

Main Results:

• Over half (52.2%) of family physicians offered MSS to all pregnant patients, with 34.6% offering it to some and 13.2% to none.
• A majority (63.6%) had not altered their MSS practice recently, though 29.5% reported offering it more frequently.
• Physicians offering MSS to all patients were more likely to be female, younger (30-39 years), Canadian-trained, and urban-practicing, but practice patterns were not associated with attitudes or knowledge.

Conclusions:

• More than half of family physicians in Newfoundland and Labrador provide maternal serum screening (MSS) to all pregnant patients, and an additional third offer it selectively.
• Physicians' decisions to offer MSS were not demonstrably linked to their personal attitudes or depth of knowledge regarding the screening.
• Further investigation may be warranted to understand the drivers behind selective MSS offering and to ensure consistent, evidence-based prenatal screening practices.