Survey of knowledge, attitudes, and practice management patterns of Atlanta-area obstetricians regarding stillbirth.
OBJECTIVE
Existing surveillance data on fetal death certificates are suboptimal for conducting reliable epidemiologic studies on stillbirth. The objective of this survey was to better understand the factors potentially affecting the quality of data collected on stillbirths among a defined population.


METHODS
A survey was mailed to all physicians (n = 661) listed in the July 2007 version of the American Medical Association master file with a primary specialty of obstetrics/gynecology and a mailing address within five counties in metropolitan Atlanta.


RESULTS
A total of 487 physicians met eligibility criteria: 279 returned the survey, 179 did not return the survey, and 29 were returned as unable to locate. Two respondents returned incomplete surveys, leaving 277 participants for the final analysis. Respondents reported seeing an average of six stillbirths per year. A cause of death was not identified in two thirds of cases. Almost half (46.8%) of participants responded that 20 weeks was the minimum gestational age defining stillbirth, whereas 33.1% responded that it was 24 weeks. A majority (92.6%) responded that a standardized definition for stillbirth should be adopted. More than 80% agreed that a comprehensive evaluation was important to identify a cause of death, and 91.9% agreed that the use of a standardized protocol for post-mortem stillbirth evaluation would be helpful. A majority also agreed that ongoing surveillance of stillbirths and a national research agenda on causes of stillbirth are important.


CONCLUSIONS
Comprehensive educational and awareness efforts for obstetricians and other related health care personnel are needed to further improve on the data collected for surveillance purposes on stillbirth.
Duke
Wes
W
Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. cduke@cdc.gov
Shin
Mikyong
M
Correa
Adolfo
A
Alverson
Clinton J
CJ
D000328:Adult; D001291:Attitude of Health Personnel; D002423:Cause of Death; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006176:Gynecology / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012307:Risk Factors; D050497:Stillbirth; D014505:Urban Population / Q000706:statistics & numerical data