Patient Versus Professional Based Psychosocial Risk Factor Screening for Adverse Pregnancy Outcomes

To identify Psychopathology, Psychosocial problems and substance use (PPS) as predictors of adverse pregnancy outcomes, two screen-and-advice instruments were developed: Mind2Care (M2C, self-report) and Rotterdam Reproductive Risk Reduction (R4U, professional’s checklist). To decide on the best clin...

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Bibliographic Details
Published in:	Maternal and child health journal Vol. 18; no. 9; pp. 2089 - 2097
Main Authors:	Quispel, Chantal, van Veen, Mieke J., Zuijderhoudt, Christianne, Steegers, Eric A. P., Hoogendijk, Witte J. G., Birnie, Erwin, Bonsel, Gouke J., Lambregtse-van den Berg, Mijke P.
Format:	Journal Article
Language:	English
Published:	Boston Springer US 01-11-2014 Springer Springer Nature B.V
Subjects:	Accuracy Adult Agreements Attitude of Health Personnel Child & adolescent psychiatry Childrens health Comparative analysis Drug use Ethnicity Female Gynecology Humans Infant, Newborn Infant, Small for Gestational Age Interviews Longitudinal Studies Mass Screening - methods Maternal and Child Health Medical screening Medicine Medicine & Public Health Mental Disorders - complications Mental Disorders - diagnosis Midwifery Netherlands - epidemiology Observational studies Obstetrics Pediatrics Population Economics Predictive Value of Tests Pregnancy Pregnancy Complications - ethnology Pregnancy Complications - etiology Pregnancy Complications - psychology Pregnancy Outcome - ethnology Pregnancy, Complications of Pregnant Women - ethnology Pregnant Women - psychology Premature birth Premature Birth - ethnology Prenatal Care - methods Professionals Psychopathology Public Health Regression Analysis Reproducibility of Results Risk Assessment - methods Risk factors Risk reduction Self Report Socioeconomic Factors Sociology Substance use Substance-Related Disorders - complications Substance-Related Disorders - diagnosis Triage - methods Womens health Netherlands Pregnancy Substance use Screening Preterm birth Psychopathology
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Summary:	To identify Psychopathology, Psychosocial problems and substance use (PPS) as predictors of adverse pregnancy outcomes, two screen-and-advice instruments were developed: Mind2Care (M2C, self-report) and Rotterdam Reproductive Risk Reduction (R4U, professional’s checklist). To decide on the best clinical approach of these risks, the performance of both instruments was compared. Observational study of 164 pregnant women who booked at two midwifery practices in Rotterdam. Women were consecutively screened with M2C and R4U. For referral to tailored care based on specific PPS risks, inter-test agreement of single risks was performed in terms of overall accuracy and positive accuracy (risk present according to both instruments). With univariate regression analysis we explored determinants of poor agreement (<90 %). For triage based on risk accumulation and for detecting women-at-risk for adverse birth outcomes, M2C and R4U sum scores were compared. Overall accuracy of single risks was high (mean 93 %). Positive accuracy was lower (mean 46 %) with poorest accuracy for current psychiatric symptoms. Educational level and ethnicity partly explained poor accuracy ( p < 0.05). Overall low PPS prevalence decreased the statistical power. For triage, M2C and R4U sum scores were interchangeable from sum scores of five or more (difference <1 %). The probability of adverse birth outcomes similarly increased with risk accumulation for both instruments, identifying 55–75 % of women-at-risk. The self-report M2C and the professional’s R4U checklist seem interchangeable for triage of women-at-risk for PPS or adverse birth outcomes. However, the instruments seem to provide complementary information if used as a guidance to tailored risk-specific care.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	1092-7875 1573-6628
DOI:	10.1007/s10995-014-1456-5