Abstract
BackgroundAlthough 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.MethodsTwelve 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.ResultsA 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%.ConclusionsThe 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.
Highlights
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
No significant differences in age, sex, number of patients seen each week, number of patients seen each year, number of deliveries, number of surgeries, percent of patient races, primary care specialty, or residency of patients were found between Collaborative Ambulatory Research Network (CARN) and non-CARN respondents; the groups were combined for this analysis
Our study demonstrates a disconnect between the published College Guidelines on both appropriate target populations for prenatal SCD screening and recommendations for folic acid supplementation and the practice behaviors of OB/GYNs
Summary
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. Sickle cell disease (SCD) affects 80,000 to 100,000 people in the United States; approximately 3 million people are carriers of sickle cell trait (SCT) [1,2]. Obstetrician/gynecologists (OB/GYNs) play an important role in SCD screening and adult patient care through their involvement with prenatal screening and pregnancy management. The purpose of this study was to assess OB/GYN SCD-related screening and prenatal management practices as recommended by the American College of Obstetricians and Gynecologists (the College)
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