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What your patients do (and don’t) want to hear from you about their pregnancy

March 2009 · Vol. 21, No. 03
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Almost all pregnant women (98%) want to be informed by their physicians about the possibility of preterm birth—even if they are not at risk and have no symptoms of preterm labor.

That’s one finding from a recent industry-sponsored survey, “Perceptions of Preterm Birth,” that involved 255 women between 22 and 30 weeks’ gestation.

In the survey, only 37% of women reported that their health-care provider discussed preterm birth with them.

Eighty-nine percent of women want to know “everything” about pregnancy, including their risk for a premature birth, but fewer than 5% expect their doctors to tell them all that they need to know.

“It appears that there is a significant perception gap between what physicians think their patients want to know about pregnancy, and what patients actually want to know,” said Christine Coleman, director of the Pregnancy Research Center, which conducted the study on behalf of Hologic, Inc., a fetal fibronectin test manufacturer.

“Many doctors believe that their patients don’t want to know about things that might go wrong, but women generally want to know everything,” Coleman said.

As one respondent put it: “I like to be informed because even if you are having a ‘textbook’ pregnancy, you never know if things will change; and I like to be informed of all possibilities in order to be as prepared as possible.”

Among the other findings:

  • 83% of respondents said that they consider it important to educate themselves on matters related to their pregnancy. Along with talking to their health-care providers, they seek information online and in books. “It’s always good to know about any risks,” one woman added. “The more you know, the more you can be aware of signs and symptoms if something does go wrong.”
  • In regard to fetal fibronectin testing, 88% of respondents said that they would feel “in control” with a positive test result, because they could prepare for the possibility of delivering preterm; 92% said they would feel reassured by a negative fetal fibronectin test. In addition, 54% said they would be likely to follow their health-care provider’s instructions to rest during pregnancy, and 93% said they would be likely to follow instructions to restrict activity after a positive fetal fibronectin test.

For more on the survey and the Pregnancy Research Center, visit

But some information falls on deaf ears

Only a small percentage of women planning a pregnancy follow recommendations for nutrition and lifestyle, according to a recent prospective cohort study from the United Kingdom.

In the study, 12,445 nonpregnant women 20 to 34 years old were interviewed about diet, physical activity, smoking, alcohol consumption, and use of nutritional supplements over the preceding 3 months. They were then asked whether they planned to become pregnant.

Of the women who did plan to become pregnant, 238 conceived within 3 months and were interviewed again. Their responses indicated that:

  • only 2.9% took 400 μg or more of folic acid daily and consumed four or fewer units of alcohol a week, compared with 0.66% of those who did not become pregnant
  • 26% of the women who became pregnant were smokers, compared with 31% of those who did not become pregnant
  • both groups were equally likely to consume five or more portions of fruit and vegetables daily (53% in each group)
  • only 57% of those who became pregnant had exercised strenuously in the preceding 3 months, compared with 64% of those who did not become pregnant.

How these findings compare with other studies

Several studies have asked women to recall folic acid intake in the peri-conceptual period, finding that fewer than half of them took the nutrient—in some studies the percentage was less than 10%.

Alcohol consumption tends to be lower in Denmark and the United States and generally varies widely by country, so the findings in regard to alcohol consumption in the UK study may not be generalizable. Indeed, in several US studies, roughly 50% of women reported drinking no alcohol in the months leading up to conception.

The study was conducted by Inskip and colleagues and published in the British Medical Journal (2009;338:b481).

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