Abstract
To identify Psychopathology, Psychosocial problems and substance use (PPS) as predictors of adverse pregnancy outcomes, two screen-and-advice instruments were developed: Mind2Care (M2C, self-report) and Rotterdam Reproductive Risk Reduction (R4U, professional’s checklist). To decide on the best clinical approach of these risks, the performance of both instruments was compared. Observational study of 164 pregnant women who booked at two midwifery practices in Rotterdam. Women were consecutively screened with M2C and R4U. For referral to tailored care based on specific PPS risks, inter-test agreement of single risks was performed in terms of overall accuracy and positive accuracy (risk present according to both instruments). With univariate regression analysis we explored determinants of poor agreement (<90 %). For triage based on risk accumulation and for detecting women-at-risk for adverse birth outcomes, M2C and R4U sum scores were compared. Overall accuracy of single risks was high (mean 93 %). Positive accuracy was lower (mean 46 %) with poorest accuracy for current psychiatric symptoms. Educational level and ethnicity partly explained poor accuracy (p < 0.05). Overall low PPS prevalence decreased the statistical power. For triage, M2C and R4U sum scores were interchangeable from sum scores of five or more (difference <1 %). The probability of adverse birth outcomes similarly increased with risk accumulation for both instruments, identifying 55–75 % of women-at-risk. The self-report M2C and the professional’s R4U checklist seem interchangeable for triage of women-at-risk for PPS or adverse birth outcomes. However, the instruments seem to provide complementary information if used as a guidance to tailored risk-specific care.
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Acknowledgments
The authors acknowledge all midwives and assistants who provided the opportunity for this study. Stichting Achmea Gezondheidszorg (SAG) is acknowledged for providing funding for this study (Grant No z-282). The funders did not participate in any part of data collection, analysis or interpretation, neither in the writing nor approval of the manuscript.
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Supplementary material 3 (XLS 33 kb) Table 3 (supplementary online table). Exploratory univariate regression analysis: determinants of poor overall accuracy of single PPS risk factors as measured by the Mind2Care (M2C) and R4U instrument among pregnant women (n = 164)
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Quispel, C., van Veen, M.J., Zuijderhoudt, C. et al. Patient Versus Professional Based Psychosocial Risk Factor Screening for Adverse Pregnancy Outcomes. Matern Child Health J 18, 2089–2097 (2014). https://doi.org/10.1007/s10995-014-1456-5
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DOI: https://doi.org/10.1007/s10995-014-1456-5