Psychosocial risk factors during pregnancy. What do family physicians ask about?

To determine whether physician characteristics affect attitudes or practices regarding assessment of psychosocial risk factors during pregnancy, and to evaluate whether an antenatal psychosocial risk factor assessment form would help family physicians.

A questionnaire asking physicians to rate the importance of information on a scale of one to five was mailed to all active members of the University of Toronto Department of Family and Community Medicine's Survey Network of Attitudes and Practice (SNAP).

A volunteer sample of physicians doing prenatal and intrapartum obstetrics who are active members of SNAP. The network is made up of full-time faculty in the University of Toronto's family practice units and teaching practice physicians (rural, suburban, and urban) who are interested in participating in research projects.

Response rate was 78%. Responses of the 45 SNAP members who did not practise obstetrics were excluded; 125 of 218 questionnaires mailed were analyzed.

Women family physicians rated the form potentially helpful more frequently than their male colleagues. Urban and suburban physicians' concerns differed from those of rural physicians. Alcohol and drug abuse, abuse in the relationship, and acceptance of the pregnancy were rated highly important by physicians. Of the physicians surveyed, 77% thought that an antenatal psychosocial risk assessment form would be of some benefit or very helpful. Only 15% indicated it would be useless or not helpful.

The importance respondents accorded to risk factors showed little correspondence to the frequency of inquiry about them. The survey confirmed our plan to design an antenatal psychosocial risk factor assessment form.