Davis Stephanie M, Anderson Britta L, Schulkin Jay, Jones Katherine, Vanden Eng Jodi, Jones Jeffrey L
Division of Global HIV/AIDS, HIV Prevention Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA,
Arch Gynecol Obstet. 2015 Mar;291(3):545-55. doi: 10.1007/s00404-014-3450-y. Epub 2014 Sep 10.
Toxoplasmosis, caused by the parasite Toxoplasma gondii, can have serious impacts on fetal development in the setting of acute maternal primary infection. The American College of Obstetricians and Gynecologists (ACOG) sought to determine current knowledge, practices, opinions, and educational preferences regarding T. gondii infection in pregnancy among ACOG members practicing prenatal care.
ACOG sent a survey to 1,056 members chosen by stratified random sampling from membership lists, including 370 participants and 686 non-participants in the Collaborative Ambulatory Research Network (CARN). Mailings were sent up to four times to nonresponders.
Survey minimum response rates were 40.3% (CARN) and 19.7% (non-CARN); response rates adjusted for imputed non-eligibility were 59.7% (CARN) and 22.6% (non-CARN). Among providers, 80.2% had diagnosed no acute maternal T. gondii infections in the past 5 years, 12.7% correctly identified the screening role of the Toxoplasma avidity test, 42.6% performed serologic T. gondii screening for at least some asymptomatic pregnant women, and 62.1% of those who so did used appropriate approaches. Providers in the northeastern United States were 2.02 times more likely to routinely screen than those in the west (p = 0.025) and female providers were 1.48 times more likely than male providers (p = 0.047). The potential educational interventions considered useful by the most practitioners were updated ACOG guidelines on screening (81.4%) and management (71.7%) for acute T. gondii infection in pregnancy.
ACOG members would benefit from educational efforts targeted at risk factor counseling and screening approaches.
由寄生虫弓形虫引起的弓形虫病，在急性母体初次感染的情况下，可对胎儿发育产生严重影响。美国妇产科医师学会（ACOG）试图确定从事产前护理的ACOG成员中，关于孕期弓形虫感染的当前知识、实践、观点及教育偏好。
ACOG从会员名单中通过分层随机抽样选出1056名成员进行调查，其中包括协作门诊研究网络（CARN）的370名参与者和686名非参与者。对未回复者最多邮寄四次调查问卷。
调查的最低回复率分别为40.3%（CARN）和19.7%（非CARN）；经估算不符合资格调整后的回复率分别为59.7%（CARN）和22.6%（非CARN）。在医疗服务提供者中，80.2%在过去5年中未诊断出任何急性母体弓形虫感染病例，12.7%正确识别了弓形虫亲和力试验的筛查作用，42.6%至少对一些无症状孕妇进行了弓形虫血清学筛查，其中62.1%采用了适当的方法。美国东北部的医疗服务提供者进行常规筛查的可能性是西部的2.02倍（p = 0.025），女性医疗服务提供者进行常规筛查的可能性是男性的1.48倍（p = 0.047）。大多数从业者认为有用的潜在教育干预措施是更新后的ACOG关于孕期急性弓形虫感染筛查（81.4%）和管理（71.7%）的指南。
针对危险因素咨询和筛查方法的教育工作将使ACOG成员受益。
