Background
Methods
Recruitment of participants
Data collection
Data analysis
Results
Baseline characteristics
High urbanisation (n = 27) | Low urbanisation (n = 18) | |||
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Nulliparous (n = 11) | Multiparous (n = 16) | Nulliparous (n = 8) | Multiparous (n = 10) | |
Mean maternal age | 33.8 | 33.7 | 28.3 | 30.5 |
Marital status | ||||
Partner | 11 | 16 | 8 | 10 |
Single | – | – | – | – |
Highest educationa
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Low | – | – | 1 | – |
Intermediate | 1 | 3 | 3 | 4 |
High | 10 | 13 | 4 | 6 |
Occupation | ||||
Paid job | 11 | 16 | 7 | 9 |
Unemployed | – | – | 1 | – |
Housewife | – | – | – | 1 |
Etnic originb
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Dutch | 9 | 14 | 8 | 10 |
Non-Dutch | 2 | 2 | – | – |
General experience with preeclampsiac
| ||||
Yes | 4 | 13 | 5 | 5 |
No | 7 | 3 | 3 | 5 |
Perception
Needs
‘It worries me that I have not been informed on this (preeclampsia) in my former pregnancy or in this pregnancy […], it is quite a serious condition, and I would have appreciated to receive a list with symptoms to be aware of, just suppose I would have had these symptoms and would not have recognised it. So I am actually more worried about the lack of information’ [F16, multiparous, highly urbanised region].
‘If you would receive information like “be aware of headache and blurred vision” and the information like how it was presented in the information video, that will possibly increase your alertness’ [P6, primiparous, low urbanised region].‘And suppose PE screening will be implemented, they (healthcare professionals) will be aware of your high-risk, and consequently be more alert, when compared to being at low-risk’ [M9, multiparous, low urbanised region].
‘….also because there will be more consultations, there will be more often a moment of reassurance. And if the healthcare professional pays close attention to my condition, this will possibly compensate my feelings of anxiety due to a high-risk” [F4, primiparous, highly urbanised region].
‘On the other hand, screening could also cause unnecessary anxiety, as women will be worried and think: “O no, I have a high-risk, so I will get this disease” [F22, multiparous, highly urbanised region].‘..I find it important to be screened, but you also have to take things as they come. It is your body doing the work and you have to trust on the signals of your body’ [M1, multiparous, low urbanised region].
Preferences
Information provision |
‘I would like to know these percentages, only information ‘you are categorised as high or low-risk’ for me is not enough, I want complete information. For example what does it mean to be at low-risk, and what are my chances of developing the condition. And what does it mean to be at high-risk and what are my chances of developing the condition then. What are options for prevention and treatment. And when I know all these things, what are my options? [F9, primiparous, highly urbanised region].
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‘Some oral information, but also some written information, so you can look the information up when you are back home’. [P8, primiparous, low urbanised region]
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Medication |
‘I am positive towards early identification of your risk, but I feel some reluctance for taking aspirin throughout my pregnancy. Calcium, for me is OK, you can find this in pregnancy vitamins as well’ [P8, primiparous, low urbanised region].
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‘I found it a bit strange, I have no medical background, but I have been told that in case of a headache or any pain, it is better not to take aspirin as a painkiller, but paracetamol instead’ [F15 multiparous, highly urbanised region].
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Choice |
I think that everybody should make their own choices (to participate or not). That is my opinion [P7, primiparous, low urbanised region]. |
‘I would like to hear this (screening for PE) afterwards. They will take a blood test anyway, and then they will do all these exams....I don’t mind. And if they inform me about this afterwards, that is early enough’ [F1, primiparous, highly urbanised region].
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‘Regarding use of aspirin and calcium, for me this should be a choice. First I would like to receive extensive information about these medicines [….] and than discuss what are the options [F4 primiparous, highly urbanised region].
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False-positive classification |
‘I fully agree…for me it would be really reassuring, because if you are determined as high-risk, there is only a 20% chance of developing the disease. Well, if I would have a chance of 80% to win the lottery, I would certainly participate. I don’t think it (high-risk identification) would worry me’ [F13, multiparous, highly urbanised region].
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Subgroup analysis
‘A gynaecologist is in a hospital, with different smell, different light....A midwife more often is close to your house, whereas a gynaecologist is not. A midwife is easy accessible, but if you have a high-risk.....well, I don’t think it is necessary to be with a gynaecologist for the rest of your pregnancy’ [M3, multiparous, low urbanised region].
‘I would prefer to have direct access to specialised care in case of any alarming symptoms or feelings of discomfort, instead of convincing someone that they have to take my complaints in serious consideration. So yes, from that point of view, being at high-risk provides me with this direct access’ [F5, primiparous, highly urbanised region].