title: Universal psychosocial screening and adverse pregnancy outcomes in an academic obstetric clinic.
abstract: OBJECTIVE
  To test the hypothesis that women screened for psychosocial factors, including partner abuse, as recommended by the American College of Obstetricians and Gynecologists would have higher neonatal birth weight, longer gestational age at delivery, higher Apgar scores, and fewer maternal complications.
  
  
  METHODS
  We evaluated a universal psychosocial screening intervention using a retrospective cohort (n=881 prenatal care patients). Pregnancy outcomes among patients screened beginning in 2008 (n=464) were compared with outcomes among women receiving care before universal screening was implemented (n=417). Data were obtained from medical records between 2007 and 2009. Multivariable logistic regression and analysis of covariance were used to estimate the association between screening and pregnancy outcomes among singleton births adjusting for confounders (prior preterm births, insurance, and mode of delivery).
  
  
  RESULTS
  Screened women were less likely than women not universally screened to have low birth weight neonates (4.5% of screened, 10.3% of unscreened; adjusted odds ratio [OR] 0.41, 95% confidence interval [CI] 0.23-0.73), preterm births (9.9% of screened, 14.9% of unscreened; adjusted OR 0.62, 95% CI 0.41-0.96), and any maternal complication (30.0% of screened, 41.2% of unscreened; adjusted OR 0.67, 95% CI 0.50-0.88). Newborn Apgar scores were higher (P=.01) among screened relative to unscreened mothers.
  
  
  CONCLUSIONS
  Our results provide evidence that universal screening was associated with improved pregnancy outcomes.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, KY, USA. ann.coker@uky.edu
authors.forename: Ann L
authors.initials: AL
authors.lastname: Coker
authors.forename: Lisandra S
authors.initials: LS
authors.lastname: Garcia
authors.forename: Corrine M
authors.initials: CM
authors.lastname: Williams
authors.forename: Tim N
authors.initials: TN
authors.lastname: Crawford
authors.forename: Emily R
authors.initials: ER
authors.lastname: Clear
authors.forename: Judith
authors.initials: J
authors.lastname: McFarlane
authors.forename: James E
authors.initials: JE
authors.lastname: Ferguson
mesh_terms: D000328:Adult; D001034:Apgar Score; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology; D011256:Pregnancy Outcome / Q000453:epidemiology* / Q000523:psychology*; D012189:Retrospective Studies; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult