Georgia State Obstetrician Counseling Practices Regarding Prenatal Environmental Toxin Exposures [3B]

Abstract

INTRODUCTION: Recent studies have underscored the adverse effects of prenatal exposure to bisphenol-A (BPA), pesticides, mercury, and lead. The purpose of this pilot study was to assess the counseling practices and level of comfort discussing prenatal environmental exposures among obstetricians in the state of Georgia. METHODS: We surveyed 100 practicing obstetricians, including Georgia private practice physicians in addition to residents and faculty from the largest residency training program in the state. RESULTS: The majority (72%) of physicians agreed that assessing environmental exposures during prenatal care is important in preventing adverse pregnancy outcomes. While 97.9% felt confident discussing cigarette smoking, few felt confident discussing the impact of other toxin exposures on pregnancy as follows: BPA (48.4%), pesticides (46.2%), mercury (42.1%), and lead (36.8%). Furthermore, less than 1 in 4 obstetricians reported routinely discussing each of these exposures as part of prenatal care: BPA (3.2%), pesticides (16.1%), mercury (22.6%), and lead (8.6%). There was no significant difference in either counseling practices or comfort discussing these topics when stratified by age, years in practice, and percentage of practice dedicated to obstetrics. CONCLUSION: Prenatal exposure to environmental toxins can have a significant impact on reproductive and developmental health, yet many obstetricians are not confident discussing the effect of environmental exposures on health outcomes with their patients. Currently most Georgia obstetricians are only evaluating a fraction of the environmental exposures recommended by the American College of Obstetricians and Gynecologists experts. There is a profound opportunity for improvement in counseling patients and educating reproductive health providers on this topic.