Comparison of perceived and actual rates of survival and freedom from handicap in premature infants.
OBJECTIVE
Our goal was to learn whether physicians delivering obstetric care accurately estimated rates of survival and freedom from handicap in premature infants.


METHODS
We surveyed by mail 409 obstetricians and general and family physicians reported to perform deliveries in Alabama to identify their perceptions regarding survival and handicap-free rates of infants born at gestational ages between 23 and 36 weeks, inclusive. Responses were compared with published national rates of survival and freedom from handicap by means of unpaired t tests.


RESULTS
A total of 224 physicians responded (55%), and 183 were still practicing obstetrics. They significantly underestimated survival rates from 23 through 34 weeks' gestation (p < 0.05) and freedom from serious handicap from 23 through 36 weeks' gestation (p < 0.05). They advocated early treatment of preterm labor, but < 50% would perform cesarean delivery for fetal distress before 26 weeks' gestation.


CONCLUSIONS
We conclude that physicians delivering obstetric care significantly underestimate survival and freedom from handicap in preterm infants. Perinatal care may be adversely affected by these misperceptions.
Haywood
J L
JL
Department of Pediatrics (Divisions of Neonatology and General Pediatrics), School of Medicine, University of Alabama at Birmingham.
Goldenberg
R L
RL
Bronstein
J
J
Nelson
K G
KG
Carlo
W A
WA
D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005194:Family Practice; D005260:Female; D005865:Gestational Age; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000628:therapy*; D009774:Obstetrics; D011247:Pregnancy; D015996:Survival Rate