Do maternal characteristics influence maternal–fetal medicine physicians’ willingness to intervene when managing periviable deliveries?

Abstract

Objective:Determine the relative influence of patient characteristics on Maternal–Fetal Medicine (MFM) physicians’ willingness to intervene when managing 23-week preterm premature rupture of membranes.Study Design:Surveyed 750 randomly sampled US members of the Society of Maternal–Fetal Medicine. Physicians rated their willingness to offer induction, order steroids and perform cesarean across eight vignettes; then completed a questionnaire querying expectations about neonatal outcomes and demographics.Results:Three hundred and twenty-five (43%) MFMs responded. Patient characteristics only influenced ⩽11% of participants’ willingness ratings. Overall, provider characteristics and institutional norms were associated with willingness to perform antenatal interventions, for example, practice region was associated with willingness to offer induction (P<0.001), order steroids (P=0.008) and perform cesarean for distress (P=0.011); while institutional cesarean cutoffs were associated with willingness to order steroids and perform cesarean for labor and distress (all P<0.001).Conclusion:Physician-level factors and institutional norms, more so than patient characteristics, may drive periviable care and outcomes.

DOI: 10.1038/jp.2016.15

Cite this paper

@article{Mckenzie2016DoMC, title={Do maternal characteristics influence maternal–fetal medicine physicians’ willingness to intervene when managing periviable deliveries?}, author={Fatima Mckenzie and Bridget K. Robinson and Brownsyne M. Tucker Edmonds}, journal={Journal of Perinatology}, year={2016}, volume={36}, pages={522-528} }