J. Perinat. Med. 2014; 42(6): 717–724
Divya Chhabraa, Jess Joymon, Ben H. Lee, Myra Mercado, Cheryl L. Hunter, Deborah Violab, Denise Tahara, Karla Damus, Edmund F. La Gamma and Heather L. Brumberg*
Delivery-related knowledge of mothers of NICU infants compared with well-baby-nursery infants Abstract Objective: The objective of this study was to compare the knowledge of mothers of newborns in a neonatal intensive care unit (NICU) and well-baby nursery (WBN) regarding their understanding of term gestation, delivery mode safety, and elective late preterm delivery. Methods: Mothers of newborns admitted to either an NICU (n = 88) or a WBN (n = 145) were surveyed (March 2008–September 2010). Results: Of all mothers, regardless of infant location, 7% were unable to define term gestation, 33% were unaware that scheduling delivery at 35–36 weeks is not advisable, and 30% lacked the knowledge that cesareans are not safer than vaginal deliveries. Multivariate regression models show that socioeconomic and demographic factors underlie many knowledge gaps, and surprisingly, models confirmed a Present address: Department of Medicine, University of California, San Diego, San Diego, CA, USA. b Present address: Center for Regional Healthcare Innovation, Valhalla, NY, USA. *Corresponding author: Dr. Heather L. Brumberg, Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children’s Hospital at Westchester Medical Center, New York Medical College, 100 Woods Road, Valhalla, NY 10595, USA, Tel.: +1 914 493 8491, Fax: +1 914 493 1005, E-mail: [email protected] Divya Chhabra and Edmund F. La Gamma: Neonatology, Maria Fareri Children’s Hospital, Valhalla, NY, USA Jess Joymon: Morristown Medical Center at Atlantic Health, Morristown, NJ, USA Ben H. Lee: Morristown Medical Center at Atlantic Health, Morristown, NJ, USA; and Atlantic Neonatal Research Institute, Morristown, NJ, USA Myra Mercado: Neonatology, Maria Fareri Children’s Hospital, Valhalla, NY, USA; and Phelps Memorial Hospital, Sleepy Hollow, NY, USA Cheryl L. Hunter: Lower Hudson Valley Perinatal Network, Valhalla, NY, USA Deborah Viola and Denise Tahara: New York Medical College, School of Health Sciences and Practice, Valhalla, NY, USA Karla Damus: Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA Heather L. Brumberg: Neonatology, Maria Fareri Children’s Hospital, Valhalla, NY, USA; Lower Hudson Valley Perinatal Network, Valhalla, NY, USA; and New York Medical College, School of Health Sciences and Practice, Valhalla, NY, USA
that the site (NICU versus WBN) of the infant was not a significant factor related to maternal knowledge. Conclusion: This study revealed gaps in mothers’ understanding of the medical implications of premature delivery even though most mothers knew the correct length of term gestation. Unexpectedly, NICU mothers who had a child with significant illness and who encountered multiple health care providers did not have improved understanding of perinatal risks. We conclude that all women need to be educated on the significance of the mode and the timing of delivery. Keywords: Cesarean section; delivery mode; knowledge; late preterm; prematurity. DOI 10.1515/jpm-2014-0258 Received April 23, 2014. Accepted July 23, 2014. Previously published online August 28, 2014.
Introduction Patient education and empowerment to make personal health care choices are a central tenet of modern medicine’s approach to public health [22]. To better understand the gaps in public knowledge and how best to address them, a growing body of literature examining maternal familiarity with the risks of the modes of delivery is emerging [1, 5, 9, 15, 23, 24, 29]. However, little data exist regarding maternal awareness related to both delivery mode and its timing. There is even less information regarding whether mothers of infants currently being treated in a neonatal intensive care unit (NICU) understand the medical implications of the treatment they received, which is disturbing given that mothers with a history of a preterm birth have a 2.5 times higher risk of a recurrent preterm delivery [10, 18]. Moreover, one would anticipate greater attention to this issue in the literature due to the much higher rate of neonatal morbidity and the need to alert women with a child in the NICU to be better informed about issues related to preterm births than, for example, those mothers of neonates in a well-baby nursery (WBN).
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718 Chhabra et al., Maternal knowledge of delivery mode and timing A recent study of maternal knowledge of appropriate timing of delivery found that 24% of mothers understood that a baby of 34–36 weeks’ gestation was full term (FT) [11]. This lack of understanding is significant considering the peak prevalence of nearly 500,000 preterm births (
Divya Chhabraa, Jess Joymon, Ben H. Lee, Myra Mercado, Cheryl L. Hunter, Deborah Violab, Denise Tahara, Karla Damus, Edmund F. La Gamma and Heather L. Brumberg*
Delivery-related knowledge of mothers of NICU infants compared with well-baby-nursery infants Abstract Objective: The objective of this study was to compare the knowledge of mothers of newborns in a neonatal intensive care unit (NICU) and well-baby nursery (WBN) regarding their understanding of term gestation, delivery mode safety, and elective late preterm delivery. Methods: Mothers of newborns admitted to either an NICU (n = 88) or a WBN (n = 145) were surveyed (March 2008–September 2010). Results: Of all mothers, regardless of infant location, 7% were unable to define term gestation, 33% were unaware that scheduling delivery at 35–36 weeks is not advisable, and 30% lacked the knowledge that cesareans are not safer than vaginal deliveries. Multivariate regression models show that socioeconomic and demographic factors underlie many knowledge gaps, and surprisingly, models confirmed a Present address: Department of Medicine, University of California, San Diego, San Diego, CA, USA. b Present address: Center for Regional Healthcare Innovation, Valhalla, NY, USA. *Corresponding author: Dr. Heather L. Brumberg, Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children’s Hospital at Westchester Medical Center, New York Medical College, 100 Woods Road, Valhalla, NY 10595, USA, Tel.: +1 914 493 8491, Fax: +1 914 493 1005, E-mail: [email protected] Divya Chhabra and Edmund F. La Gamma: Neonatology, Maria Fareri Children’s Hospital, Valhalla, NY, USA Jess Joymon: Morristown Medical Center at Atlantic Health, Morristown, NJ, USA Ben H. Lee: Morristown Medical Center at Atlantic Health, Morristown, NJ, USA; and Atlantic Neonatal Research Institute, Morristown, NJ, USA Myra Mercado: Neonatology, Maria Fareri Children’s Hospital, Valhalla, NY, USA; and Phelps Memorial Hospital, Sleepy Hollow, NY, USA Cheryl L. Hunter: Lower Hudson Valley Perinatal Network, Valhalla, NY, USA Deborah Viola and Denise Tahara: New York Medical College, School of Health Sciences and Practice, Valhalla, NY, USA Karla Damus: Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA Heather L. Brumberg: Neonatology, Maria Fareri Children’s Hospital, Valhalla, NY, USA; Lower Hudson Valley Perinatal Network, Valhalla, NY, USA; and New York Medical College, School of Health Sciences and Practice, Valhalla, NY, USA
that the site (NICU versus WBN) of the infant was not a significant factor related to maternal knowledge. Conclusion: This study revealed gaps in mothers’ understanding of the medical implications of premature delivery even though most mothers knew the correct length of term gestation. Unexpectedly, NICU mothers who had a child with significant illness and who encountered multiple health care providers did not have improved understanding of perinatal risks. We conclude that all women need to be educated on the significance of the mode and the timing of delivery. Keywords: Cesarean section; delivery mode; knowledge; late preterm; prematurity. DOI 10.1515/jpm-2014-0258 Received April 23, 2014. Accepted July 23, 2014. Previously published online August 28, 2014.
Introduction Patient education and empowerment to make personal health care choices are a central tenet of modern medicine’s approach to public health [22]. To better understand the gaps in public knowledge and how best to address them, a growing body of literature examining maternal familiarity with the risks of the modes of delivery is emerging [1, 5, 9, 15, 23, 24, 29]. However, little data exist regarding maternal awareness related to both delivery mode and its timing. There is even less information regarding whether mothers of infants currently being treated in a neonatal intensive care unit (NICU) understand the medical implications of the treatment they received, which is disturbing given that mothers with a history of a preterm birth have a 2.5 times higher risk of a recurrent preterm delivery [10, 18]. Moreover, one would anticipate greater attention to this issue in the literature due to the much higher rate of neonatal morbidity and the need to alert women with a child in the NICU to be better informed about issues related to preterm births than, for example, those mothers of neonates in a well-baby nursery (WBN).
Brought to you by | Georgetown University Authenticated Download Date | 5/23/15 1:43 AM
718 Chhabra et al., Maternal knowledge of delivery mode and timing A recent study of maternal knowledge of appropriate timing of delivery found that 24% of mothers understood that a baby of 34–36 weeks’ gestation was full term (FT) [11]. This lack of understanding is significant considering the peak prevalence of nearly 500,000 preterm births (
