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Content Analysis of Patient-Facing Information Related to Preeclampsia

Published:October 31, 2022DOI:https://doi.org/10.1016/j.whi.2022.09.003

      Abstract

      Background

      Previous research has shown pregnant people are not knowledgeable about preeclampsia, a significant cause of maternal morbidity and mortality. This lack of knowledge may impact their ability to report symptoms, comply with recommendations, and receive appropriate follow-up care. Pregnant people commonly seek information from sources outside their treating clinician, including pregnancy-specific books and online sources. We examined commonly used preeclampsia information sources to evaluate whether pregnant people are receiving up-to-date, guideline-based information.

      Methods

      We conducted a content analysis of preeclampsia-related information in top-ranking websites and bestselling pregnancy books. We used American College of Obstetricians and Gynecologists preeclampsia guidelines to construct a codebook, which we used to examine source content completeness and accuracy. For each source, we analyzed information about preeclampsia diagnosis, patient-reported symptoms, risk factors, prevention, treatment, and complications.

      Results

      Across 19 included sources (13 websites and 6 books), we found substantial variation in completeness and accuracy of preeclampsia information. We found high rates of mentions for preeclampsia symptoms. Risk factors were more commonly included in online sources than book sources. Most sources mentioned treatment options, including blood pressure medication and giving birth; however, one-third of online sources positively mentioned the nonrecommended treatment of bed rest. Prevention methods, including prenatal aspirin for high-risk pregnancies, and long-term complications of preeclampsia were infrequently mentioned.

      Conclusions

      Varying rates of accuracy in patient-facing preeclampsia information mean there is substantial room for improvement in these sources. Ensuring pregnant people receive current guideline-based information is critical for improving outcomes and implementing shared decision-making.
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      Biography

      Kimberley H. Geissler, PhD, is an Associate Professor in Health Policy and Management, Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst. Her research examines factors affecting access to and coordination of health care.

      Biography

      Valerie Evans, MS, MSc, is a Biostatistician/Data Base Manager in the Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst. Her research interests include global public health policy and practice.

      Biography

      Michael I. Cooper, BBA, is a medical student at Tufts University School of Medicine and a Departmental Assistant in the Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst. His research interests include health care quality, delivery, and policy.

      Biography

      Susan J. Shaw, PhD, is an Associate Professor in Community Health Education, Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst. Her research examines ethnographic and qualitative research methods, health disparities, chronic disease, and health literacy.

      Biography

      Christina Yarrington, MD, FACOG, is Director, Labor and Delivery at Boston Medical Center and Assistant Professor of Obstetrics & Gynecology, Boston University School of Medicine. Her research examines the link between pregnancy complications and whole women health over the life course as well as disparities in perinatal health.

      Biography

      Laura B. Attanasio, PhD, is an Assistant Professor in Health Policy and Management, Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst. Her research examines issues of quality, equity and decision making in perinatal health care.