Comparing preferences of pregnant women, pediatricians and obstetricians for two strategies to reduce GBS infection in neonates

Academic Article

Abstract

  • Purpose: To compare parents' and physicians' preferences for the American College of Obstetrics and Gynecology (ACOG) and the American Academy of Pediatrics' (AAP) policies for reducing the incidence of neonatal Group B Streptococcal (GBS) sepsis using the Analytic Hierarchy Process (AHP) model, and to assess their acceptance of the AHP. Methods: 93 pregnant women, 40 pediatricians and 40 obstetricians randomly selected and interviewed with an interactive computer AHP model. The goal of the model was to choose the best GBS policy for the mother and infant. Decisions were based on five objectives shown in the table below. Results: 89% of the pregnant women and 100% of the physicians selected provided responses that could be analyzed. 80.7% of the pregnant women and 65% of the pediatricians preferred the AAP strategy. Only 15% of obstetricians preferred the AAP strategy. Compared to mothers, obstetricians (OR=25.3; p<0.001) and pediatricians (OR=2.4;p=0.045) were more likely to prefer the ACOG strategy. Ranking of priorities was: Objectives Pregnant women Pediatricians Obstetricians Rank Mean Score Rank Mean Score Rank Mean Score Minimize baby infection 1 .254 1 .443 1 .411 Knowledge of maternal GBS status 2 .226 4 .142 5 .099 Minimize risk to mother 3 .196 3 .144 3 .164 Minimize tests for baby 4 .166 2 .153 2 .173 Minimize cost 5 .156 5 .116 4 .154 90% of the respondents reported comprehending the interview format. 75% of obstetricians, 87.5% of pediatricians and 86.7% of mothers liked the interview. Only 42.5% of obstetricians thought doctors should use this kind of interview for their patients, compared to 72.5% of pediatricians and 88% of mothers. Conclusions: Mothers and pediatricians preferred the AAP strategy. Obstetricians preferred the ACOG strategy. The three groups agreed that minimizing the risk of infection to the baby had the highest priority. Priorities are different between pregnant women, pediatricians and obstetricians. Therefore uniform policy recommendations may not be appropriate.
  • Published In

    Author List

  • Peralta M; Fargason CA; Dolan J; Coston D
  • Volume

  • 44
  • Issue

  • 1