Use and attitudes of obstetricians toward 3 high-risk interventions in MFMU Network hospitals Presented in part at the 32nd annual meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, Feb. 6-11, 2012.

Sabine Zoghbi Bousleiman, Madeline Murguia Rice, Joan Moss, Allison Todd, Monica Rincon, Gail Mallett, Cynthia Milluzzi, Donna Allard, Karen Dorman, Felecia Ortiz, Francee Johnson, Peggy Reed, Susan Tolivaisa, R. Wapner, C. Ananth, L. Plante, M. Hoffman, S. Lort, A. Ranzini, George Saade & 39 others Maged Costantine, J. Brandon, Gary Hankins, Ashley Salazar, A. Tita, W. Andrews, J. E. Tolosa, A. Lawrence, C. Clock, M. Blaser, M. Nichols, L. Pereira, A. Peaceman, M. Dinsmoor, J. Senka, K. Paychek, B. Mercer, J. Bailit, D. Rouse, B. Anderson, J. Tillinghast, M. Jimenez, S. Timlin, S. Blackwell, J. Iams, M. Varner, K. Hill, V. Morby, G. Anderson, E. Thom, L. Doherty, C. Swartz, B. Broderick, P. McGee, Y. Zhao, T. Spangler, G. Sandoval, C. Spong, J. P. Van Dorsten

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective We sought to evaluate the frequency of, and factors associated with, the use of 3 evidence-based interventions: antenatal corticosteroids for fetal lung maturity, progesterone for prevention of recurrent preterm birth, and magnesium sulfate for fetal neuroprotection. Study Design A self-administered survey was conducted from January through May 2011 among obstetricians from 21 hospitals that included 30 questions regarding their knowledge, attitudes, and practice of the 3 evidence-based interventions and the 14-item short version of the Team Climate for Innovation survey. Frequency of use of each intervention was ascertained from an obstetrical cohort of women between January 2010 and February 2011. Results A total of 329 obstetricians (74% response rate) who managed 16,946 deliveries within the obstetrical cohort participated in the survey. More than 90% of obstetricians reported that they incorporated each intervention into routine practice. Actual frequency of administration in women eligible for the treatments was 93% for corticosteroids, 39% for progesterone, and 71% for magnesium sulfate. Provider satisfaction with quality of treatment evidence was 97% for corticosteroids, 82% for progesterone, and 57% for magnesium sulfate. Obstetricians perceived that barriers to treatment were most frequent for progesterone (76%), 30% for magnesium sulfate, and 17% for corticosteroids. Progesterone use was more frequent among patients whose provider reported the quality of the evidence was above average to excellent compared with poor to average (42% vs 25%, respectively; P <.001), and they were satisfied with their knowledge of the intervention (41% vs 28%; P =.02), and was less common among patients whose provider reported barriers to hospital or pharmacy drug delivery (31% vs 42%; P =.01). Corticosteroid administration was more common among patients who delivered at hospitals with 24 hours a day-7 days a week maternal-fetal medicine specialist coverage (93% vs 84%; P =.046), Conclusion Obstetricians in Maternal-Fetal Medicine Units Network hospitals frequently use these evidence-based interventions; however, progesterone use was found to be related to their assessment of evidence quality. Neither progesterone nor the other interventions were associated with overall climate of innovation within a hospital as measured by the Team Climate for Innovation. National Institutes of Health Consensus Conference Statements may also have an impact on use; there is such a statement for antenatal corticosteroids but not for progesterone for preterm prevention or magnesium sulfate for fetal neuroprotection.

Original languageEnglish (US)
Pages (from-to)398e1-398e11
JournalAmerican Journal of Obstetrics and Gynecology
Volume213
Issue number3
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

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Progesterone
Magnesium Sulfate
Adrenal Cortex Hormones
Climate
Mothers
Medicine
Health Knowledge, Attitudes, Practice
Hospital Units
Premature Birth
National Institutes of Health (U.S.)
Consensus
Therapeutics
Lung
Pharmaceutical Preparations
Surveys and Questionnaires

Keywords

  • antenatal corticosteroids
  • evidence-based interventions
  • magnesium sulfate
  • Maternal-Fetal Medicine Units Network
  • progesterone

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Use and attitudes of obstetricians toward 3 high-risk interventions in MFMU Network hospitals Presented in part at the 32nd annual meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, Feb. 6-11, 2012. / Bousleiman, Sabine Zoghbi; Rice, Madeline Murguia; Moss, Joan; Todd, Allison; Rincon, Monica; Mallett, Gail; Milluzzi, Cynthia; Allard, Donna; Dorman, Karen; Ortiz, Felecia; Johnson, Francee; Reed, Peggy; Tolivaisa, Susan; Wapner, R.; Ananth, C.; Plante, L.; Hoffman, M.; Lort, S.; Ranzini, A.; Saade, George; Costantine, Maged; Brandon, J.; Hankins, Gary; Salazar, Ashley; Tita, A.; Andrews, W.; Tolosa, J. E.; Lawrence, A.; Clock, C.; Blaser, M.; Nichols, M.; Pereira, L.; Peaceman, A.; Dinsmoor, M.; Senka, J.; Paychek, K.; Mercer, B.; Bailit, J.; Rouse, D.; Anderson, B.; Tillinghast, J.; Jimenez, M.; Timlin, S.; Blackwell, S.; Iams, J.; Varner, M.; Hill, K.; Morby, V.; Anderson, G.; Thom, E.; Doherty, L.; Swartz, C.; Broderick, B.; McGee, P.; Zhao, Y.; Spangler, T.; Sandoval, G.; Spong, C.; Van Dorsten, J. P.

In: American Journal of Obstetrics and Gynecology, Vol. 213, No. 3, 01.09.2015, p. 398e1-398e11.

Research output: Contribution to journalArticle

Bousleiman, SZ, Rice, MM, Moss, J, Todd, A, Rincon, M, Mallett, G, Milluzzi, C, Allard, D, Dorman, K, Ortiz, F, Johnson, F, Reed, P, Tolivaisa, S, Wapner, R, Ananth, C, Plante, L, Hoffman, M, Lort, S, Ranzini, A, Saade, G, Costantine, M, Brandon, J, Hankins, G, Salazar, A, Tita, A, Andrews, W, Tolosa, JE, Lawrence, A, Clock, C, Blaser, M, Nichols, M, Pereira, L, Peaceman, A, Dinsmoor, M, Senka, J, Paychek, K, Mercer, B, Bailit, J, Rouse, D, Anderson, B, Tillinghast, J, Jimenez, M, Timlin, S, Blackwell, S, Iams, J, Varner, M, Hill, K, Morby, V, Anderson, G, Thom, E, Doherty, L, Swartz, C, Broderick, B, McGee, P, Zhao, Y, Spangler, T, Sandoval, G, Spong, C & Van Dorsten, JP 2015, 'Use and attitudes of obstetricians toward 3 high-risk interventions in MFMU Network hospitals Presented in part at the 32nd annual meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, Feb. 6-11, 2012.', American Journal of Obstetrics and Gynecology, vol. 213, no. 3, pp. 398e1-398e11. https://doi.org/10.1016/j.ajog.2015.05.005
Bousleiman, Sabine Zoghbi ; Rice, Madeline Murguia ; Moss, Joan ; Todd, Allison ; Rincon, Monica ; Mallett, Gail ; Milluzzi, Cynthia ; Allard, Donna ; Dorman, Karen ; Ortiz, Felecia ; Johnson, Francee ; Reed, Peggy ; Tolivaisa, Susan ; Wapner, R. ; Ananth, C. ; Plante, L. ; Hoffman, M. ; Lort, S. ; Ranzini, A. ; Saade, George ; Costantine, Maged ; Brandon, J. ; Hankins, Gary ; Salazar, Ashley ; Tita, A. ; Andrews, W. ; Tolosa, J. E. ; Lawrence, A. ; Clock, C. ; Blaser, M. ; Nichols, M. ; Pereira, L. ; Peaceman, A. ; Dinsmoor, M. ; Senka, J. ; Paychek, K. ; Mercer, B. ; Bailit, J. ; Rouse, D. ; Anderson, B. ; Tillinghast, J. ; Jimenez, M. ; Timlin, S. ; Blackwell, S. ; Iams, J. ; Varner, M. ; Hill, K. ; Morby, V. ; Anderson, G. ; Thom, E. ; Doherty, L. ; Swartz, C. ; Broderick, B. ; McGee, P. ; Zhao, Y. ; Spangler, T. ; Sandoval, G. ; Spong, C. ; Van Dorsten, J. P. / Use and attitudes of obstetricians toward 3 high-risk interventions in MFMU Network hospitals Presented in part at the 32nd annual meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, Feb. 6-11, 2012. In: American Journal of Obstetrics and Gynecology. 2015 ; Vol. 213, No. 3. pp. 398e1-398e11.
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title = "Use and attitudes of obstetricians toward 3 high-risk interventions in MFMU Network hospitals Presented in part at the 32nd annual meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, Feb. 6-11, 2012.",
abstract = "Objective We sought to evaluate the frequency of, and factors associated with, the use of 3 evidence-based interventions: antenatal corticosteroids for fetal lung maturity, progesterone for prevention of recurrent preterm birth, and magnesium sulfate for fetal neuroprotection. Study Design A self-administered survey was conducted from January through May 2011 among obstetricians from 21 hospitals that included 30 questions regarding their knowledge, attitudes, and practice of the 3 evidence-based interventions and the 14-item short version of the Team Climate for Innovation survey. Frequency of use of each intervention was ascertained from an obstetrical cohort of women between January 2010 and February 2011. Results A total of 329 obstetricians (74{\%} response rate) who managed 16,946 deliveries within the obstetrical cohort participated in the survey. More than 90{\%} of obstetricians reported that they incorporated each intervention into routine practice. Actual frequency of administration in women eligible for the treatments was 93{\%} for corticosteroids, 39{\%} for progesterone, and 71{\%} for magnesium sulfate. Provider satisfaction with quality of treatment evidence was 97{\%} for corticosteroids, 82{\%} for progesterone, and 57{\%} for magnesium sulfate. Obstetricians perceived that barriers to treatment were most frequent for progesterone (76{\%}), 30{\%} for magnesium sulfate, and 17{\%} for corticosteroids. Progesterone use was more frequent among patients whose provider reported the quality of the evidence was above average to excellent compared with poor to average (42{\%} vs 25{\%}, respectively; P <.001), and they were satisfied with their knowledge of the intervention (41{\%} vs 28{\%}; P =.02), and was less common among patients whose provider reported barriers to hospital or pharmacy drug delivery (31{\%} vs 42{\%}; P =.01). Corticosteroid administration was more common among patients who delivered at hospitals with 24 hours a day-7 days a week maternal-fetal medicine specialist coverage (93{\%} vs 84{\%}; P =.046), Conclusion Obstetricians in Maternal-Fetal Medicine Units Network hospitals frequently use these evidence-based interventions; however, progesterone use was found to be related to their assessment of evidence quality. Neither progesterone nor the other interventions were associated with overall climate of innovation within a hospital as measured by the Team Climate for Innovation. National Institutes of Health Consensus Conference Statements may also have an impact on use; there is such a statement for antenatal corticosteroids but not for progesterone for preterm prevention or magnesium sulfate for fetal neuroprotection.",
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author = "Bousleiman, {Sabine Zoghbi} and Rice, {Madeline Murguia} and Joan Moss and Allison Todd and Monica Rincon and Gail Mallett and Cynthia Milluzzi and Donna Allard and Karen Dorman and Felecia Ortiz and Francee Johnson and Peggy Reed and Susan Tolivaisa and R. Wapner and C. Ananth and L. Plante and M. Hoffman and S. Lort and A. Ranzini and George Saade and Maged Costantine and J. Brandon and Gary Hankins and Ashley Salazar and A. Tita and W. Andrews and Tolosa, {J. E.} and A. Lawrence and C. Clock and M. Blaser and M. Nichols and L. Pereira and A. Peaceman and M. Dinsmoor and J. Senka and K. Paychek and B. Mercer and J. Bailit and D. Rouse and B. Anderson and J. Tillinghast and M. Jimenez and S. Timlin and S. Blackwell and J. Iams and M. Varner and K. Hill and V. Morby and G. Anderson and E. Thom and L. Doherty and C. Swartz and B. Broderick and P. McGee and Y. Zhao and T. Spangler and G. Sandoval and C. Spong and {Van Dorsten}, {J. P.}",
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TY - JOUR

T1 - Use and attitudes of obstetricians toward 3 high-risk interventions in MFMU Network hospitals Presented in part at the 32nd annual meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, Feb. 6-11, 2012.

AU - Bousleiman, Sabine Zoghbi

AU - Rice, Madeline Murguia

AU - Moss, Joan

AU - Todd, Allison

AU - Rincon, Monica

AU - Mallett, Gail

AU - Milluzzi, Cynthia

AU - Allard, Donna

AU - Dorman, Karen

AU - Ortiz, Felecia

AU - Johnson, Francee

AU - Reed, Peggy

AU - Tolivaisa, Susan

AU - Wapner, R.

AU - Ananth, C.

AU - Plante, L.

AU - Hoffman, M.

AU - Lort, S.

AU - Ranzini, A.

AU - Saade, George

AU - Costantine, Maged

AU - Brandon, J.

AU - Hankins, Gary

AU - Salazar, Ashley

AU - Tita, A.

AU - Andrews, W.

AU - Tolosa, J. E.

AU - Lawrence, A.

AU - Clock, C.

AU - Blaser, M.

AU - Nichols, M.

AU - Pereira, L.

AU - Peaceman, A.

AU - Dinsmoor, M.

AU - Senka, J.

AU - Paychek, K.

AU - Mercer, B.

AU - Bailit, J.

AU - Rouse, D.

AU - Anderson, B.

AU - Tillinghast, J.

AU - Jimenez, M.

AU - Timlin, S.

AU - Blackwell, S.

AU - Iams, J.

AU - Varner, M.

AU - Hill, K.

AU - Morby, V.

AU - Anderson, G.

AU - Thom, E.

AU - Doherty, L.

AU - Swartz, C.

AU - Broderick, B.

AU - McGee, P.

AU - Zhao, Y.

AU - Spangler, T.

AU - Sandoval, G.

AU - Spong, C.

AU - Van Dorsten, J. P.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Objective We sought to evaluate the frequency of, and factors associated with, the use of 3 evidence-based interventions: antenatal corticosteroids for fetal lung maturity, progesterone for prevention of recurrent preterm birth, and magnesium sulfate for fetal neuroprotection. Study Design A self-administered survey was conducted from January through May 2011 among obstetricians from 21 hospitals that included 30 questions regarding their knowledge, attitudes, and practice of the 3 evidence-based interventions and the 14-item short version of the Team Climate for Innovation survey. Frequency of use of each intervention was ascertained from an obstetrical cohort of women between January 2010 and February 2011. Results A total of 329 obstetricians (74% response rate) who managed 16,946 deliveries within the obstetrical cohort participated in the survey. More than 90% of obstetricians reported that they incorporated each intervention into routine practice. Actual frequency of administration in women eligible for the treatments was 93% for corticosteroids, 39% for progesterone, and 71% for magnesium sulfate. Provider satisfaction with quality of treatment evidence was 97% for corticosteroids, 82% for progesterone, and 57% for magnesium sulfate. Obstetricians perceived that barriers to treatment were most frequent for progesterone (76%), 30% for magnesium sulfate, and 17% for corticosteroids. Progesterone use was more frequent among patients whose provider reported the quality of the evidence was above average to excellent compared with poor to average (42% vs 25%, respectively; P <.001), and they were satisfied with their knowledge of the intervention (41% vs 28%; P =.02), and was less common among patients whose provider reported barriers to hospital or pharmacy drug delivery (31% vs 42%; P =.01). Corticosteroid administration was more common among patients who delivered at hospitals with 24 hours a day-7 days a week maternal-fetal medicine specialist coverage (93% vs 84%; P =.046), Conclusion Obstetricians in Maternal-Fetal Medicine Units Network hospitals frequently use these evidence-based interventions; however, progesterone use was found to be related to their assessment of evidence quality. Neither progesterone nor the other interventions were associated with overall climate of innovation within a hospital as measured by the Team Climate for Innovation. National Institutes of Health Consensus Conference Statements may also have an impact on use; there is such a statement for antenatal corticosteroids but not for progesterone for preterm prevention or magnesium sulfate for fetal neuroprotection.

AB - Objective We sought to evaluate the frequency of, and factors associated with, the use of 3 evidence-based interventions: antenatal corticosteroids for fetal lung maturity, progesterone for prevention of recurrent preterm birth, and magnesium sulfate for fetal neuroprotection. Study Design A self-administered survey was conducted from January through May 2011 among obstetricians from 21 hospitals that included 30 questions regarding their knowledge, attitudes, and practice of the 3 evidence-based interventions and the 14-item short version of the Team Climate for Innovation survey. Frequency of use of each intervention was ascertained from an obstetrical cohort of women between January 2010 and February 2011. Results A total of 329 obstetricians (74% response rate) who managed 16,946 deliveries within the obstetrical cohort participated in the survey. More than 90% of obstetricians reported that they incorporated each intervention into routine practice. Actual frequency of administration in women eligible for the treatments was 93% for corticosteroids, 39% for progesterone, and 71% for magnesium sulfate. Provider satisfaction with quality of treatment evidence was 97% for corticosteroids, 82% for progesterone, and 57% for magnesium sulfate. Obstetricians perceived that barriers to treatment were most frequent for progesterone (76%), 30% for magnesium sulfate, and 17% for corticosteroids. Progesterone use was more frequent among patients whose provider reported the quality of the evidence was above average to excellent compared with poor to average (42% vs 25%, respectively; P <.001), and they were satisfied with their knowledge of the intervention (41% vs 28%; P =.02), and was less common among patients whose provider reported barriers to hospital or pharmacy drug delivery (31% vs 42%; P =.01). Corticosteroid administration was more common among patients who delivered at hospitals with 24 hours a day-7 days a week maternal-fetal medicine specialist coverage (93% vs 84%; P =.046), Conclusion Obstetricians in Maternal-Fetal Medicine Units Network hospitals frequently use these evidence-based interventions; however, progesterone use was found to be related to their assessment of evidence quality. Neither progesterone nor the other interventions were associated with overall climate of innovation within a hospital as measured by the Team Climate for Innovation. National Institutes of Health Consensus Conference Statements may also have an impact on use; there is such a statement for antenatal corticosteroids but not for progesterone for preterm prevention or magnesium sulfate for fetal neuroprotection.

KW - antenatal corticosteroids

KW - evidence-based interventions

KW - magnesium sulfate

KW - Maternal-Fetal Medicine Units Network

KW - progesterone

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