title: Assessment and care for non-medical risk factors in current antenatal health care.
abstract: OBJECTIVE
  this study aims to identify current practice in risk assessment, current antenatal policy and referral possibilities for non-medical risk factors (lifestyle and social risk factors), and to explore the satisfaction among obstetric caregivers in their collaboration with non-obstetrical caregivers.
  
  
  METHODS
  cross-sectional study
  
  
  METHODS
  Dutch antenatal care system
  
  
  METHODS
  community midwives from 139 midwifery practices and gynaecologists, hospital-based midwives, and trainees in obstetrics from 38 hospitals.
  
  
  RESULTS
  results were analysed with χ(2) tests and unpaired t-tests. Caregivers universally screened upon lifestyle risk factors (e.g. smoking or drug use), whereas the screening for social risk factors (e.g. social support) was highly variable. As national guidelines are absent, local protocols were reported to be used for screening on non-medical risk factors in more than 40%. Caregivers stated multidisciplinary protocols to be a prerequisite for assessment of non-medical risk factors. Only 22% of the caregivers used predefined criteria to define when patients should be discussed multidisciplinary.
  
  
  CONCLUSIONS
  despite their relevance, non-medical risk factors remain an underexposed topic in antenatal risk factor screening in both the community and hospital-based care setting. Implications for practice Structural antenatal risk assessment for non-medical risk factors with subsequent consultation opportunities is advocated, preferably based on a multidisciplinary guideline.
authors.affiliation: Erasmus University Medical Centre, Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: a.a.vos@erasmusmc.nl.
authors.forename: Amber A
authors.initials: AA
authors.lastname: Vos
authors.affiliation: Erasmus University Medical Centre, Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: Annemiek
authors.initials: A
authors.lastname: Leeman
authors.affiliation: Erasmus University Medical Centre, Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: Adja J M
authors.initials: AJ
authors.lastname: Waelput
authors.affiliation: Erasmus University Medical Centre, Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Erasmus University Rotterdam, Department of Public Health, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: Gouke J
authors.initials: GJ
authors.lastname: Bonsel
authors.affiliation: Erasmus University Medical Centre, Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.affiliation: Erasmus University College, Department of Social & Behavioural Sciences, Nieuwemarkt 1A, 3011 HP Rotterdam, The Netherlands.
authors.forename: Semiha
authors.initials: S
authors.lastname: Denktaş
mesh_terms: D000428:Alcohol Drinking / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008880:Midwifery / Q000379:methods*; D009035:Mothers / Q000193:education; D009426:Netherlands / Q000453:epidemiology; D024802:Nurse's Role; D010348:Patient Care Team / Q000458:organization & administration; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D000074606:Smoking Prevention; D012944:Social Support; D012959:Socioeconomic Factors
keywords: Antenatal health care policy; Collaboration; Guidelines; Non-medical risk factors; Risk assessment