Knowledge, Attitudes and Practices of Maternity Care Providers Concerning Prevention of Congenital and Neonatal Infections

Abstract

Background: Pregnant women are at risk for influenza-related complications, while their children are at risk for influenza or pertussis associated morbidity 1 . Influenza and pertussis vaccination is proven safe and effective during pregnancy, while recommendation from maternity care providers is strongly associated with vaccine uptakes 2,3 . Moreover, counseling of pregnant women on congenital infections is important. Objective: To investigate Greek providers' knowledge, attitudes and practices around congenital and neonatal diseases' screening, prevention and vaccination strategies. Methods: A pilot questionnaire was distributed through Survey Monkey to a convenient sample of Obstetricians/Gynecologists (Ob/ Gyns). Moreover, it was completed by a convenient sample of Midwives, during their annual meeting. Results :• In total, 202 responded: -102 Ob/ Gyns (72.5% > 40 years old, 23.7% female) and -100 Midwives (23.5% >40 years old, 98% female).• Both Ob/ Gyns and Midwives claimed discussing congenital infection prevention strategies during prenatal visits (90%), specifically hand hygiene (94.5%) and eating properly washed vegetables and well-cooked meat (97.5%). Fewer though advised pregnant women to avoid young children's saliva (58.7%) and gardening without gloves (58.3%).• The majority of providers tested pregnant women during the 1 st trimester for antibodies against CMV and Toxoplasma and retested if seronegative (97% and 85% respectively).• Regarding pregnancy, postpartum and family vaccination, many providers suggested influenza vaccine (73.8%, 65% and 61.4% respectively). Then again, most do not recommend pertussis vaccine (64.3%, 69% and 64.2% respectively).•Univariate analysis: -Ob/ Gyns: suggesting avoidance of young children's' saliva during pregnancy was associated with recommendation of gardening with gloves (p=0.016) and also providers who retested a seronegative woman were more likely to retest her every trimester (p<0.001).-Midwives: age <40 years old was associated with non-recommendation of pregnancy, postpartum and family pertussis vaccination (p=0.008, 0.008 and 0.05 respectively), while Midwives believed that antibodies should be retested every trimester and at the end of pregnancy if CMV and toxoplasma seronegative (p<0.001 both).-Both specialties: vaccinating pregnant women against influenza was associated with postpartum and family influenza vaccination (p<0.001 both).-Comparing the two specialty groups: Ob/ Gyns were more likely than Midwives, to discuss congenital infection prevention strategies during prenatal visits, like suggesting gardening with gloves, to retest pregnant women for CMV and Toxoplasma antibodies if seronegative at 1 st trimester and to suggest pregnancy, postpartum and family influenza vaccination, but not pregnancy pertussis vaccination (Table 1).• Multiple logistic regression analysis revealed that specialty and suggestion of avoiding children's saliva during pregnancy were independently associated with discussion of congenital infection prevention strategies durin...