Waller Amy, Bryant Jamie, Cameron Emilie, Galal Mohamed, Quay Juliana, Sanson-Fisher Rob
Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, HMRI Building, Callaghan, NSW, 2308, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.
BMC Pregnancy Childbirth. 2016 Jul 27;16(1):191. doi: 10.1186/s12884-016-0984-y.
Detection and management of antenatal risk factors is critical for improved maternal and infant outcomes. This study describes the proportion of pregnant women who self-reported being screened for and offered advice to manage antenatal risk factors in line with antenatal care recommendations; and the characteristics associated with rates of screening.
A survey was undertaken with 223 (64 % of eligible) pregnant women recruited from an outpatient obstetrics clinic at a public hospital. Participants self-reported whether they were: (i) screened for 23 guideline-recommended risk factors during their antenatal visit; (ii) offered assistance to manage identified risk factor(s); and (iii) received assistance that was of benefit. Association between rate of screening and participant characteristics was examined using multivariate quantile regression.
Overall, 23 % of women reported that they were asked about every risk factor. Weight gain (48 %), diet (60 %) and oral health (31 %) were least frequently screened risk factors. The number of women who reported they were offered advice to manage identified risks and the value of that advice was perceived by women as suboptimal. Those women receiving shared care between a midwife and general practitioner, of Aboriginal or Torres Strait Islander descent, and without private health insurance reported being screened for a greater number of risk factors.
Pregnant women report suboptimal rates of screening and management of antenatal risk factors. Initiatives to improve consistency in detection of antenatal risk factors and the application of appropriate interventions to manage those risk factors that are detected are required.
产前风险因素的检测与管理对于改善母婴结局至关重要。本研究描述了根据产前护理建议自我报告接受产前风险因素筛查并获得管理建议的孕妇比例；以及与筛查率相关的特征。
对从一家公立医院的门诊产科诊所招募的223名（符合条件者的64%）孕妇进行了一项调查。参与者自我报告她们是否：（i）在产前检查期间接受了针对23项指南推荐的风险因素的筛查；（ii）获得了管理已识别风险因素的帮助；以及（iii）接受了有益的帮助。使用多变量分位数回归研究筛查率与参与者特征之间的关联。
总体而言，23%的女性报告她们被问及了每一项风险因素。体重增加（48%）、饮食（60%）和口腔健康（31%）是筛查频率最低的风险因素。报告获得管理已识别风险的建议的女性人数以及女性认为该建议的价值都不尽人意。那些接受助产士和全科医生共同护理、有原住民或托雷斯海峡岛民血统且没有私人医疗保险的女性报告接受了更多风险因素的筛查。
孕妇报告产前风险因素的筛查和管理率不尽人意。需要采取措施提高产前风险因素检测的一致性，并对检测到的风险因素应用适当的干预措施进行管理。
