Background
Methods
Recruitment
Eligibility Criteria
Questionnaire
Outcomes
Sample size calculation
Statistical Analysis
Results
Recruitment results
Characteristics of survey respondents
Variable | Response, n (%)a
|
---|---|
Pregnant Women’s Characteristics | |
Age (years), mean ± SD | 30.9 (5.4) |
Gestational age (weeks), median (interquartile range) | 32.0 (26.7, 35.7) |
European/White-Caucasian (self-reported) | 252 (82.1) |
Married or in a common-law relationship | 292 (94.5) |
Education | |
Secondary school or less | 48 (15.5) |
Post-secondary school | 262 (84.5) |
Current smokers | 23 (7.4) |
Obstetric History | |
Prior miscarriage | 28 (14.7) |
Prior full-term birth (≥37 weeks) | 150 (48.5) |
Prior preterm birth (<37 weeks) | 25 (13.2) |
Received progesterone | 2 (8.0) |
Advised to rest in bed (bedrest) | 1 (4.0) |
Current Pregnancy Characteristics | |
First-time pregnancy | 119 (38.5) |
Told by healthcare provider that they were at increased risk for preterm birth | 13 (4.2) |
Received ultrasound | 10 (76.9) |
Received ultrasound + progesterone | 1 (7.7) |
Preference for PTB prevention
Variablesa
| Preferred no preventionb, (n = 198) | Preferred preventionc (n = 103) | p-value for differenced
|
---|---|---|---|
Pregnant Women’s Characteristics | |||
Age (years), mean ± SD | 30.7 (5.6) | 31.0 (5.1) | 0.64 |
European or White-Caucasian ethnicity (self-reported) | 167 (85.6) | 90 (88.2) | 0.59 |
Post-secondary education | 164 (82.8) | 90 (87.4) | 0.32 |
Married or in common-law relationship | 185 (93.9) | 99 (96.1) | 0.59 |
Current Smokers | 14 (7.1) | 8 (7.8) | 0.82 |
Primary Healthcare Provider | |||
Obstetrician | 87 (43.9) | 49 (47.1) | 0.42 |
Family physician | 62 (31.3) | 37 (35.6) | |
Midwife | 40 (20.2) | 13 (12.5) | |
Otherse
| 9 (4.6) | 5 (4.8) | |
Obstetric History | |||
Prior full-term birth | 95 (79.8) | 51 (76.1) | 0.58 |
Prior preterm birth | 14 (11.8) | 11 (16.2) | 0.50 |
Prior use of preterm birth prevention | 2 (14.3) | 1 (9.1) | 1.00 |
Received progesterone | 0 (0.0) | 1 (50.0) | 1.00 |
Advised to rest in bed (bedrest) | 1 (100.0) | 1 (50.0) | 1.00 |
Current Pregnancy Characteristics | |||
Gestational age at point of survey completion (weeks), mean ± SDf
| 31.0 (7.6) | 29.6 (7.5) | 0.12 |
At increased risk for preterm birth | 12 (6.1) | 1 (1.0) | 0.04 |
Preterm Birth Prevention Preferences | |||
Preferred no close-monitoring nor prevention | 13 (6.6) | ||
Preferred close-monitoring only | 185 (93.4) | ||
Preferred close-monitoring and prevention | 15 (14.6) | ||
Preferred progesterone only | 13 (86.7) | ||
Preferred cerclage only | 1 (6.7) | ||
Preferred all 3 preventions | 1 (6.7) | ||
Preferred preterm birth prevention only | 88 (85.4) | ||
Selected 1 prevention only | 53 (60.2) | ||
Progesterone only | 45 (84.9) | ||
Cerclage only | 5 (9.4) | ||
Pessary only | 3 (5.7) | ||
Selected 2 preventions | 18 (20.4) | ||
Progesterone + Cerclage | 8 (44.4) | ||
Progesterone + Pessary | 9 (50.0) | ||
Cerclage + Pessary | 1 (5.6) | ||
Selected all 3 preventions | 25 (24.3) |
Issue | Number of responses, n
| Not at all important, n (%) | Slightly not important, n (%) | Neutral, n (%) | Slightly important, n (%) | Extremely important,n (%) |
---|---|---|---|---|---|---|
Potential Harm Caused to Baby | ||||||
Progesterone | 309 | 1 (0.3) | 1 (0.3) | 7 (2.3) | 8 (2.6) | 292 (94.5) |
Cerclage | 306 | 2 (0.6) | 2 (0.6) | 4 (1.3) | 9 (2.9) | 289 (94.4) |
Pessary | 307 | 2 (0.6) | 2 (0.6) | 9 (2.9) | 9 (2.9) | 285 (92.8) |
Potential Harm Caused to Mother | ||||||
Progesterone | 309 | 4 (1.3) | 6 (1.9) | 20 (6.5) | 86 (27.8) | 193 (62.5) |
Cerclage | 306 | 5 (1.6) | 5 (1.6) | 14 (4.6) | 60 (19.6) | 222 (72.5) |
Pessary | 307 | 3 (1.0) | 5 (1.6) | 18 (5.9) | 71 (23.1) | 210 (68.4) |
Effectiveness of Prevention | ||||||
Progesterone | 309 | 1 (0.3) | 4 (1.3) | 29 (9.4) | 67 (21.7) | 239 (78.1) |
Cerclage | 306 | 2 (0.6) | 3 (1.0) | 22 (7.2) | 40 (13.1) | 239 (78.1) |
Pessary | 307 | 2 (0.6) | 3 (1.0) | 26 (8.5) | 52 (16.9) | 224 (73.0) |
Associated Financial Cost | ||||||
Progesterone | 309 | 92 (29.8) | 38 (12.3) | 75 (24.3) | 65 (21.0) | 39 (12.6) |
Likelihood of following healthcare provider’s recommendation for PTB prevention
Variablesa
| Progesterone | Cerclage | Pessary | ||||||
---|---|---|---|---|---|---|---|---|---|
Unlikely to follow recommendationb (n = 27) | Undecided or likely to follow recommendationc (n = 220) | p-valued
| Unlikely to follow recommendationb (n = 123) | Undecided or likely to follow recommendationc (n = 122) | p-valued
| Unlikely to follow recommendationb (n = 70) | Undecided or likely to follow recommendationc (n = 174) | p-valued
| |
Pregnant Women’s Characteristics | |||||||||
Age 30 and over | 13 (48.1) | 146 (66.4) | 0.09 | 78 (63.4) | 81 (66.4) | 0.59 | 41 (59.4) | 117 (67.2) | 0.30 |
European or White- Caucasian ethnicity (self-reported) | 23 (85.2) | 197 (90.8) | 0.32 | 109 (88.6) | 108 (90.8) | 0.67 | 58 (84.1) | 159 (92.4) | 0.06 |
Post-secondary education | 23 (85.2) | 190 (86.8) | 0.77 | 104 (84.6) | 106 (87.6) | 0.58 | 57 (82.6) | 153 (87.9) | 0.30 |
Married or in common-law relationship | 22 (81.5) | 212 (96.8) | 0.005 | 116 (94.3) | 116 (95.9) | 0.77 | 65 (94.2) | 167 (96.0) | 0.51 |
Current Smokers | 3 (11.1) | 18 (8.2) | 0.71 | 9 (7.3) | 13 (10.7) | 0.38 | 4 (5.8) | 17 (9.8) | 0.45 |
Primary Healthcare Provider | |||||||||
Obstetrician | 12 (44.4) | 80 (36.4) | 0.32 | 42 (34.2) | 50 (41.0) | 0.26 | 27 (38.6) | 64 (38.8) | 0.52 |
Family physician | 7 (25.9) | 39 (17.7) | 27 (22.0) | 18 (14.8) | 16 (22.9) | 29 (16.7) | |||
Midwife | 8 (29.6) | 89 (40.4) | 46 (37.4) | 50 (41.0) | 23 (32.9) | 73 (42.0) | |||
Otherse
| 0 (0.0) | 12 (5.4) | 8 (6.5) | 4 (3.3) | 4 (5.7) | 8 (4.6) | |||
Obstetric History | |||||||||
Prior full-term birth | 13 (48.1) | 107 (48.6) | 0.13 | 58 (47.2) | 60 (49.2) | 0.84 | 32 (45.7) | 86 (49.4) | 0.46 |
Prior preterm birth | 2 (7.4) | 17 (7.7) | 0.67 | 6 (4.9) | 12 (9.8) | 0.21 | 3 (7.9) | 15 (13.9) | 0.40 |
Prior use of preterm birth prevention | 1 (50.0) | 2 (11.8) | 0.31 | 1 (16.7) | 2 (16.7) | 1.00 | 0 (0.0) | 3 (20.0) | 1.00 |
Current Pregnancy Characteristics | |||||||||
Third trimester at point of survey completion | 17 (63.0) | 155 (70.8) | 0.50 | 87 (71.3) | 84 (68.8) | 0.78 | 47 (67.1) | 123 (71.1) | 0.54 |
Increased risk for preterm birth | 1 (3.7) | 9 (4.1) | 1.00 | 2 (1.6) | 7 (5.7) | 0.10 | 0 (0.0) | 9 (5.2) | 0.06 |
Preterm Birth Prevention Preferences and Issues | |||||||||
Preferred no prevention | 20 (76.9) | 137 (63.7) | 0.20 | 96 (78.7) | 61 (52.1) | <0.0001 | 56 (80.0) | 100 (59.5) | 0.003 |
Likely to have concerns about potential harm to baby | 27 (100.0) | 213 (96.8) | 1.00 | 118 (95.9) | 118 (96.7) | 1.00 | 66 (94.3) | 165 (94.8) | 1.00 |
Likely to have concerns about potential harm to mother | 23 (85.2) | 201 (91.4) | 0.29 | 111 (90.2) | 112 (91.2) | 0.82 | 62 (88.6) | 158 (90.8) | 0.64 |
Likely to have concerns about efficacy | 25 (92.6) | 196 (89.1) | 0.75 | 112 (91.1) | 111 (91.0) | 1.00 | 60 (85.7) | 158 (90.8) | 0.26 |
Likely to have concerns about cost | 13 (48.2) | 67 (30.4) | 0.08 |
Variablesa
| Progesterone | Cerclage | Pessary | |||
---|---|---|---|---|---|---|
Multivariate Analysis OR (95% CIs) | p-valueb
| Multivariate Analysis OR (95% CIs) | p-valueb
| Multivariate Analysis OR (95% CIs) | p-valueb
| |
Pregnant Women’s Characteristics | ||||||
European or White-Caucasian ethnicity (self-reported) | 0.41 (0.17, 1.01) | 0.05 | ||||
Not married or in common-law relationship | 5.88 (1.72, 20.00) | 0.0049 | ||||
Preterm Birth Prevention Issuesc
| ||||||
Preference for no prevention | 3.39 (1.93, 5.96) | <0.0001 | 2.99 (1.51, 5.92) | 0.002 |