110 - A Visit to the Pediatrician as a Part of Comprehensive Prenatal Care?

Poster Number: 110
Publication Number: 110.410

Tiffany L. Mei, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Andrew Aligne, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Jessica L. VanScott, University of Rochester, Center for Community Practice, Rochester, NY, United States

Background: The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend that expectant parents have a preventive visit with a pediatrician in the prenatal period. The pediatric prenatal visit (PPV) allows time for expectant parents to meet with a pediatrician and receive anticipatory guidance on topics such as breastfeeding, childhood immunizations, circumcision, newborn screening, and general newborn care. The visit is also an opportunity to discuss family history, parental preferences, and psychosocial and environmental concerns. Discussing newborn health topics in the prenatal period tends to be more effective than immediately postpartum, when new mothers may be less receptive to processing information. Research suggests, for example, that the PPV increases timely childhood immunizations. While 73% of pediatricians offer prenatal visits, only 22% of expectant parents have one, and there are significant disparities by race and income.

Objective: To assess the current knowledge, attitudes, and practices regarding referral of pregnant patients for a pediatric prenatal visit.

Design/Methods: A 2-minute online survey was emailed to 367 obstetric providers in Rochester, NY. Of these, 304 were eligible to take the survey. Simple descriptive statistics and chi-square analyses were applied to survey responses.

Results: Ninety obstetric providers completed the survey. Among respondents, 73% (66/90) reported awareness of the PPV and 50% (45/90) reported referring patients for a PPV. However, responses to open-ended questions revealed confusion between the PPV and a “meet and greet” with a pediatrician. Some respondents provide information to patients only if patients ask about pediatricians. Attitudes toward the visit among providers who had received one as a parent themselves were positive. Patient lack of knowledge was the most common perceived barrier to a PPV. Some respondents also incorrectly believe that the PPV is not covered by insurance.Conclusion(s): The limited literature on this topic suggests that national adherence with professional guidelines for pediatric prenatal visits has been low for decades. These results indicate little improvement despite passage of the Affordable Care Act over a decade ago and updated guidelines from the AAP and ACOG in 2017. Unfamiliarity with the rationale or existence of these visits remains common. This suggests that educating both patients and obstetrics providers about the guidelines, evidence, and insurance coverage for these visits could increase referrals and reduce disparities in utilization and child health outcomes.
Tiffany Mei CVTiffany Mei CV PAS_2022.pdf
Table 2Selected Survey Comments on Barriers to Referral and Patient Knowledge