Streamlining Universal Prenatal Screening for Risk for Adverse Birth Outcomes

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Psychosocial Health

Background:

• Routine prenatal care monitors medical risks but often overlooks psychosocial factors like maternal stress, anxiety, depression, and intimate partner violence.
• These psychosocial factors are significant contributors to adverse birth outcomes, including preeclampsia.
• Comprehensive screening for psychosocial risks can enhance maternal and neonatal health outcomes.

Purpose of the Study:

• To evaluate an existing prenatal risk screening tool for potential streamlining and improvement.
• To identify a more efficient method for screening psychosocial risk factors in pregnant individuals.
• To enhance the identification of mothers at risk for adverse birth outcomes.

Main Methods:

• A retrospective review of medical records for 528 mother-infant dyads was conducted.
• Maternal responses to a 21-item prenatal risk screening tool were recorded.
• Infant gestational age and birth weight were documented, and multiple scoring approaches were used to predict adverse birth outcomes.

Main Results:

• Women answering "yes" to any of the top four interrelated screening items showed a 3.32 times higher likelihood of an adverse birth outcome.
• The screening tool demonstrated a sensitivity of 68% and a specificity of 65% in predicting adverse outcomes.
• A subset of the screening tool effectively identified high-risk pregnancies.

Conclusions:

• A concise surveillance tool was identified to effectively flag women at the highest risk for adverse birth outcomes, necessitating further in-depth screening.
• The tool also aids in ruling out women at very low risk, optimizing resource allocation.
• Streamlining psychosocial risk screening can lead to timely interventions and improved pregnancy outcomes.