First-trimester preeclampsia screening and prevention: impact on patient satisfaction and anxiety

Katherine Silang; Lianne Tomfohr-Madsen; Connor Maxey; Melanie Pastuck; Jo-Ann Johnson

doi:10.1016/j.xagr.2023.100205

First-trimester preeclampsia screening and prevention: impact on patient satisfaction and anxiety

AJOG Glob Rep. 2023 Apr 5;3(2):100205. doi: 10.1016/j.xagr.2023.100205. eCollection 2023 May.

Authors

Katherine Silang^{1

2}, Lianne Tomfohr-Madsen³, Connor Maxey⁴, Melanie Pastuck⁴, Jo-Ann Johnson⁴

Affiliations

¹ Department of Psychology, University of Calgary, Calgary, Canada (Ms Silang).
² Alberta Children's Hospital Research Institute, Calgary, Canada (Ms Silang).
³ Department of Educational & Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, Canada (Dr Tomfohr-Madsen).
⁴ Department of Obstetrics and Gynaecology, University of Calgary, Calgary, Canada (Mr Maxey, Ms Pastuck, and Dr Johnson).

Abstract

Background: Preeclampsia affects between 2% and 5% of pregnant people in North America. First-trimester preeclampsia screening based on the Fetal Medicine Foundation risk calculation algorithm combined with treatment of high-risk patients with aspirin effectively reduces the incidence of preterm preeclampsia more than the currently used risk factor-based screening. However, the impact of such screening on patient satisfaction and maternal anxiety is unknown.

Objective: This study aimed to assess the impact of first-trimester prediction and prevention of preterm preeclampsia on patient satisfaction and anxiety.

Study design: Consenting pregnant patients participating in a local first-trimester (11-13+6 weeks) preterm preeclampsia screening and prevention implementation study¹ were contacted 6 weeks postpartum to complete an online patient satisfaction survey, designed to assess their satisfaction with the screening program and their levels of trait anxiety (using an abbreviated version of the State-Trait Anxiety Inventory [STAIT-5]). In addition to assessing overall patient satisfaction, the level of patient satisfaction was stratified and compared according to levels of patient risk for preterm preeclampsia.

Results: Between June 2021 and December 2021, surveys were emailed to 765 participants. The response rate was 47.80% (358/765). Overall, 93% of participants reported high levels of satisfaction with preterm preeclampsia screening (70%-100%), and 98% stated that they would recommend the screening to all pregnant patients. With respect to levels of satisfaction with the program's support in reducing feelings of worry and anxiety, 87.9% of the total sample reported high satisfaction (70%-100%). The level of clinically significant symptoms of anxiety did not differ significantly between low- and high-risk groups (8% vs 10.8%, respectively).

Conclusion: Overall, first-trimester preeclampsia screening was associated with high patient satisfaction and did not lead to differences in patient anxiety between those with high- and low-risk screen results.