Impact of an education campaign on management in pregnancy of women infected with a blood-borne virus

OBJECTIVE: To assess obstetricians antenatal screening practice for blood-borne viruses (HIV, hepatitis B and C viruses [HBV and HCV]) and knowledge about management during labour and risk of transmission via breastfeeding for infected women after an educational intervention, Australia. DESIGN: Cohort study, with surveys before and after an educational intervention. SETTING AND PARTICIPANTS: Survey 1 was mailed in 2002-2003 to all 767 Fellows registered with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), and Survey 2 was mailed in 2004 to the 743 of these Fellows who were still practising. INTERVENTION: Multifaceted intervention with mail-out of survey results and a summary of recommended management, publication of two review articles in the RANZCOG journal, and an oral presentation at the RANZCOG annual scientific meeting. MAIN OUTCOME MEASURES: Self-reported frequency of antenatal screening for blood-borne viruses, change in practice based on a woman s infection status, and advice given about risk of virus transmission via breastfeeding in Survey 2, compared with Survey 1. RESULTS: Survey 2 (response rate, 68 ) found increases from the previous survey in the proportion of respondents reporting they always offered antenatal screening for HIV, from 51 to 59 , and for HCV, from 60 to 69 (P = 0.001 for both). For women with HIV infection, the proportion of respondents always recommending elective caesarean section increased from 37 to 49 (P = 0.001) and always avoiding rupture of membranes increased from 33 to 49 (P <0.001). The proportion who reported advising (incorrectly) that breastfeeding is associated with increased risk of transmission to the infant decreased...