Vaccination and perinatal infection prevention practices among obstetrician–gynecologists

doi:10.1016/S0029-7844(03)00010-3

Obstetrics & Gynecology

Volume 101, Issue 4, April 2003, Pages 704-710

https://doi.org/10.1016/S0029-7844(03)00010-3 Get rights and content

Abstract

Objective

To assist efforts to improve adult vaccination coverage by characterizing vaccination and infectious disease screening practices of obstetrician–gynecologists.

Methods

A written survey of demographics, attitudes, and practices was mailed to 1063 American College of Obstetricians and Gynecologists Fellows, including the Collaborative Ambulatory Research Network (n = 413) and 650 randomly sampled Fellows.

Results

Seventy-four percent of Collaborative Ambulatory Research Network members and 44% of nonmembers responded. A majority (Collaborative Ambulatory Research Network members: 60%; nonmembers: 49%) considered themselves primary care providers. Fewer than 60% routinely obtained patient vaccination or infection histories. Most screened prenatal patients for hepatitis B surface antigen (89%) and rubella immunoglobulin G antibody (85%). Sixty-four percent worked in practices that offered at least one vaccine; the most common were rubella (52%) and influenza (50%). Ten percent worked in practices that offered all major vaccines recommended for pregnant or postpartum women. Despite recommendations to provide influenza vaccine to pregnant women during influenza season, only 44% did so; among those who did not, 14% reported a belief that pregnant women do not need influenza vaccine. Provision of vaccine was associated with working in a multispecialty practice (adjusted odds ratio [OR] 2.6, 95% confidence interval [CI] 1.6, 4.1) and identifying as a primary care provider (adjusted OR 1.9; 95% CI 1.3, 2.7). The most common reasons for not offering vaccines were cost (44%) and a belief that vaccines should be provided elsewhere (41%).

Conclusion

The high proportion of obstetrician–gynecologists who do not offer vaccines or screen for vaccine and infection histories suggests missed opportunities for prevention of maternal and neonatal infections.

Section snippets

Materials and methods

In February 2001, anonymous questionnaires (available upon request) focusing on infectious disease screening, vaccination practices, and attitudes toward current and new vaccines were mailed to two groups of Fellows of the American College of Obstetricians and Gynecologists (ACOG), a professional organization with over 43,000 members. The first group, the Collaborative Ambulatory Research Network, consisted of ACOG Fellows who volunteer to participate regularly in surveys to help ACOG monitor

Results

Completed surveys were received from 307 Collaborative Ambulatory Research Network members (74%) and 286 nonmembers (44%). Respondents who had not seen obstetric patients in 2000 (two Collaborative Ambulatory Research Network member respondents and eight nonmember respondents) were excluded. In both groups, a majority of respondents were male obstetrician–gynecologists, rather than specialists in either obstetrics or gynecology, and practiced in urban or suburban settings (Table 1). Although

Discussion

Obstetrician–gynecologists can play a key role in protecting women and newborns from vaccine-preventable diseases.¹¹ Although internists, family physicians, and health departments have traditionally been viewed as the primary platform for delivering adult vaccinations, more than half of the ACOG members who responded to our survey considered themselves primary care providers. Only approximately two thirds, however, worked in practices that offered at least one vaccine type, and only 10% worked

Acknowledgements

The authors thank M. Gamble for data management, and A. Benin, S. Bloom, K. Galil, and J. Seward for contributions to the survey and analysis.

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^☆: This study was funded in part by Grant MC-00105 from the United States Department of Health and Human Services, Bureau of Maternal and Child Health.

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Original researchVaccination and perinatal infection prevention practices among obstetrician–gynecologists☆

Abstract

Objective

Methods

Results

Conclusion

Section snippets

Materials and methods

Results

Discussion

Acknowledgements

Obstet Gynecol

Obstet Gynecol

Infect Dis Clin North Am

Am J Obstet Gynecol

Obstet Gynecol

Obstet Gynecol

Preterm laborEmerging role of genital tract infections

Infect Agents Dis

DeathsLeading causes for 1999

Natl Vital Stat Rep

Hepatitis B virusA comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: Recommendations of the Immunization Practices Advisory Committee (ACIP)

MMWR Morb Mortal Wkly Rep

Control and prevention of rubellaEvaluation and management of suspected outbreaks, rubella in pregnant women, and surveillance for congenital rubella syndrome

MMWR Morb Mortal Wkly Rep

Original research
Vaccination and perinatal infection prevention practices among obstetrician–gynecologists☆