Azonobi Ijeoma C, Anderson Britta L, Byams Vanessa R, Grant Althea M, Schulkin Jay
The American College of Obstetricians and Gynecologists, Washington, DC, USA.
BMC Pregnancy Childbirth. 2014 Oct 14;14:356. doi: 10.1186/1471-2393-14-356.
Although obstetrician/gynecologists (OB/GYNs) play an important role in sickle cell disease (SCD) screening and patient care, there is little information on knowledge of SCD or sickle cell trait (SCT) or related practices in this provider group. Our objective was to assess SCD screening and prenatal management practices among OB/GYNs.
Twelve hundred Fellows and Junior Fellows of the American College of Obstetricians and Gynecologists (the College)a were invited to complete a mailed survey, of which half (n = 600) belonged to the Collaborative Ambulatory Research Network.b Participants answered questions regarding appropriate target patient groups for prenatal SCD screening, folic acid requirements, practice behaviors and adequacy of their medical school and residency training.
A total of 338 CARN members (56.3%) and 165 non-CARN members (27.5%) returned a survey. Of the 503 responders, 382 provided obstetric services and were included in the analyses. Forty percent of these respondents (n = 153) reported seeing at least 1 patient with SCD in the last year. Of these, 97.4% reported regularly screening people of African descent for SCD or SCT, whereas 52.9% reported regularly screening people of Mediterranean descent and 30.1% reported regularly screening people of Asian descent. Only 56.2% knew the correct recommended daily dose of folic acid for pregnant women with SCD. The proportion of respondents that rated training on SCD screening, assessment and treatment as barely adequate or inadequate ranged from 19.7% to 39.3%.
The practice of many OB/GYNs who care for patients with SCD are not consistent with the College Practice Guidelines on the screening of certain target groups and on folic acid supplementation. There may be an opportunity to improve this knowledge gap through enhanced medical education.
尽管妇产科医生在镰状细胞病（SCD）筛查及患者护理方面发挥着重要作用，但关于该医疗服务群体对SCD或镰状细胞性状（SCT）的了解情况及相关实践的信息却很少。我们的目的是评估妇产科医生的SCD筛查及产前管理实践情况。
邀请了1200名美国妇产科医师学会（该学会）的会员和初级会员完成一项邮寄调查，其中一半（n = 600）属于协作门诊研究网络。参与者回答了有关产前SCD筛查的合适目标患者群体、叶酸需求、实践行为以及他们医学院和住院医师培训是否充分等问题。
共有338名协作门诊研究网络成员（56.3%）和165名非协作门诊研究网络成员（27.5%）回复了调查。在503名回复者中，382名提供产科服务并被纳入分析。这些受访者中有40%（n = 153）报告称在过去一年中至少见过1例SCD患者。其中，97.4%报告定期对非洲裔人群进行SCD或SCT筛查，而52.9%报告定期对地中海裔人群进行筛查，30.1%报告定期对亚裔人群进行筛查。只有56.2%的人知道SCD孕妇推荐的正确叶酸每日剂量。将SCD筛查、评估和治疗培训评为勉强足够或不足的受访者比例在19.7%至39.3%之间。
许多照顾SCD患者的妇产科医生的实践与该学会关于某些目标群体筛查和叶酸补充的实践指南不一致。通过加强医学教育可能有机会缩小这一知识差距。
