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Obstetrician-gynecologists' screening and management of preterm birth

Maria A Morgan1, Robert L Goldenberg, Jay Schulkin

  • 1American College of Obstetricians and Gynecologists, Washington, DC 20024, USA. mmorgan@acog.org

Obstetrics and Gynecology
|July 2, 2008
PubMed

Insights

Obstetrician-gynecologists screen for preterm birth risk factors, but practices vary. While most use recommended interventions, some may over- or under-screen for infections and overuse bed rest.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Neonatology

Background:

  • Preterm birth remains a leading cause of neonatal morbidity and mortality.
  • Identifying risk factors and implementing timely interventions are crucial for improving outcomes.
  • Current screening and intervention practices among obstetrician-gynecologists warrant investigation.

Purpose of the Study:

  • To define obstetrician-gynecologists' screening practices for preterm birth risk factors.
  • To identify interventions used when patients are at increased risk for preterm birth.

Main Methods:

  • A survey was distributed to members of the American College of Obstetricians and Gynecologists.
  • Response rate was 59%.

Main Results:

  • Most screen for prior preterm birth (98%) and cone biopsy (95%).
  • Practices vary for screening asymptomatic urinary tract infections (21% do not screen) and group B streptococci (57% screen).
  • Most use tocolytics (98%) and corticosteroids (nearly 100%) for preterm birth, but bed rest is recommended by 31% for twin pregnancies. Referral to maternal-fetal medicine specialists is more common when a neonatal intensive care unit (ICU) is unavailable.

Conclusions:

  • Most obstetrician-gynecologists align with current findings on preterm birth risk factors and interventions.
  • Potential exists for overscreening/underscreening of infections and overuse of bed rest.
  • Physicians appropriately seek specialized care for imminent preterm births.
Abstract

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