title: Assessment of screening, treatment, and prevention of perinatal infections in the Philadelphia birth cohort.
abstract: Certain population groups are at risk for inadequate prenatal care and transmission of perinatal infections. Philadelphia's birth cohort comprises largely at-risk groups and its infant mortality rate is among the nation's highest. This study identifies factors associated with infectious disease screening, treatment, and prevention in Philadelphia. Delivery charts for a probability sample of 550 patients were reviewed. Demographic factors associated with prenatal and delivery care were identified through Pearson chi-square, analysis of variance, and stepwise logistic regression analysis. Nonstandard and incomplete documentation complicated abstraction. Some prenatal care was noted in 95% of the records and screening varied by disease. Factors independently associated with care include maternal race, insurance status, and maternal age. Screening for infections with well-established recommendations (hepatitis B virus, rubella, syphilis) occurred more often than for group B streptococcus, HIV, hepatitis C virus, and varicella. Adoption of standard reporting forms and processes could improve practice and aid in quality improvement efforts and patient communication.
authors.affiliation: Delaware Valley Hepatitis Treatment, Research, and Education Center (HepTREC), Ardmore, Pennsylvania, and Quality Insights of Pennsylvania, Wayne, Pennsylvania, USA. amy.jessop@heptrec.org
authors.forename: Amy B
authors.initials: AB
authors.lastname: Jessop
authors.forename: Barbara
authors.initials: B
authors.lastname: Watson
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mazar
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Andrel
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control / Q000458:organization & administration*; D008403:Mass Screening; D018743:Perinatal Care; D015143:Philadelphia; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy