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596: The effectiveness of enhanced teachable moments (Charlas) on prenatal vitamin knowledge among disadvantaged women in the Dominican Republic
Poster Session IV
ajog.org identification of 36 causes out of 51 (70,6%) previously unexplained stillbirths (p<0,01). CONCLUSION: The added value of a thorough placental examination in the identification of the cause of stillbirth is undeniable. The adoption of a standardised classification of stillbirth that includes such examination is necessary in order to facilitate the identification, management and ultimately the prevention of such adverse outcome.
of initiating prenatal vitamins for each group (range 79-100%) (p < 0.05 for all groups). CONCLUSION: Charlas are an effective means of engaging underserved women regarding preconceptional counseling. In Dominican women, with limited knowledge of vitamin use and intake, charlas can effectively convey the importance taking as well as when to begin these supplements.
597 Mosaic Trisomy 16: What are the obstetric and longterm childhood outcomes? Teresa N. Sparks1, Kao Thao1, Jenny Pelagio Castillo2, Mary E. Norton1 1
University of California, San Francisco, San Francisco, CA, 2University of California, Berkeley, Berkeley, CA
596 The effectiveness of enhanced teachable moments (Charlas) on prenatal vitamin knowledge among disadvantaged women in the Dominican Republic Erin M. Walker1, Cristina A. Rabaza1, Weston J. Bertot1, Erich T. Wyckoff, MD1, Luis Esmurdoc2, Robert S. Egerman, MD1 1
University of Florida, Gainesville, FL, 2Universidad Catolica de Nordestana, San Francisco de Macorís, Dominican Republic
OBJECTIVE: Medical schools are increasingly promoting initiatives in global health and firsthand experience through medical mission trips. Medical missions have the potential for benefitting patients if performed responsibly and in a culturally relevant manner. Our purpose was to assess the efficacy of small talks or “charlas” in promoting knowledge of prenatal vitamins in underserved Dominican women. STUDY DESIGN: We recruited patients seeking care at the Universidad Catolica Nordestana (UCNE) /University of Florida (UF) medical mission in San Francisco de Macorís in the Dominican Republic. Female subjects between the age of 18 and 50 gave verbal consent to participate in the study. The patients’ baseline preconceptional knowledge was assessed, after which they were provided a brief culturally engaging educational session known as a charla. A post assessment was performed. Women were stratified based on educational level (less than 5th grade education, 5th to 8th grade education, high school or university education). Comparisons between groups were made using Chi square and Fisher’s exact tests where appropriate. RESULTS: Seventy three women participated with educational levels: < 5th grade (n¼13), 5th to 8th grade (n¼24), high school (n¼22), university (n¼14). Knowledge that prenatal vitamins could help prevent birth defects differed among groups with affirmative answers in 34%, 54%, 59% and 86% of those with educational experience less than 5th grade, 5th to 8th grade, high school and university groups, respectively (p¼0.04). After completing the charla, the vast majority recognized the benefits of prenatal vitamins and differences no longer existed between the groups (p ¼ 0.47). Correspondingly, knowledge of when to initiate these vitamins was lacking amongst all groups (range 25% to 43% of women). Charlas demonstrated statistically significant improvements regarding the appropriate timing
OBJECTIVE: To examine obstetric and childhood outcomes of pregnancies with fetal mosaic trisomy 16 (MT16) or confined placental mosaicism (CPM) of T16. As T16 is potentially detectable by cell free DNA screening, a more thorough understanding of outcomes is essential for both management and counseling. STUDY DESIGN: In this cross-sectional survey study, we recruited participants through the Disorders of Chromosome 16 Foundation, an international organization including parents of children with chromosome 16 aberrations. Interviews were conducted with parents of children with MT16 or CPM based on chorionic villus sampling, amniocentesis, and/or postnatal testing. Information was gathered about diagnosis, expectations based on prenatal counseling, obstetric and neonatal course, and neurodevelopmental outcomes. Physical, emotional, social, and school functioning for each child was evaluated via the Pediatric Quality of Life Inventory version 4.0. RESULTS: Parents of 35 MT16 and CPM cases were interviewed. The median age of children was 5.3 years (0.75-19.3y), median maternal age at birth was 34y (28-41y), and 70.3% of children were female. Obstetric and childhood outcomes are described in the table. Parents expected poor outcomes based on prenatal counseling, including a median of 3.5 for learning capability on a scale of 1-10 (1 being worst imaginable outcome), 3 for chronic medical issues, and 4.5 for major birth defects. In contrast, 76.9% of school age children were entirely in mainstream classes, and 96.0% were at the appropriate grade level. Further, median physical and psychosocial function scores were high: 89 (50-100) and 85 (43-100), respectively (100 being optimal functioning). CONCLUSION: Preterm birth, hypertension, SGA, and cesarean delivery are common with both MT16 and CPM. While some congenital anomalies are prevalent, the vast majority of children have normal neurodevelopmental outcomes, including school performance as well as physical and psychosocial quality of life.
Supplement to JANUARY 2016 American Journal of Obstetrics & Gynecology
S319
ajog.org identification of 36 causes out of 51 (70,6%) previously unexplained stillbirths (p<0,01). CONCLUSION: The added value of a thorough placental examination in the identification of the cause of stillbirth is undeniable. The adoption of a standardised classification of stillbirth that includes such examination is necessary in order to facilitate the identification, management and ultimately the prevention of such adverse outcome.
of initiating prenatal vitamins for each group (range 79-100%) (p < 0.05 for all groups). CONCLUSION: Charlas are an effective means of engaging underserved women regarding preconceptional counseling. In Dominican women, with limited knowledge of vitamin use and intake, charlas can effectively convey the importance taking as well as when to begin these supplements.
597 Mosaic Trisomy 16: What are the obstetric and longterm childhood outcomes? Teresa N. Sparks1, Kao Thao1, Jenny Pelagio Castillo2, Mary E. Norton1 1
University of California, San Francisco, San Francisco, CA, 2University of California, Berkeley, Berkeley, CA
596 The effectiveness of enhanced teachable moments (Charlas) on prenatal vitamin knowledge among disadvantaged women in the Dominican Republic Erin M. Walker1, Cristina A. Rabaza1, Weston J. Bertot1, Erich T. Wyckoff, MD1, Luis Esmurdoc2, Robert S. Egerman, MD1 1
University of Florida, Gainesville, FL, 2Universidad Catolica de Nordestana, San Francisco de Macorís, Dominican Republic
OBJECTIVE: Medical schools are increasingly promoting initiatives in global health and firsthand experience through medical mission trips. Medical missions have the potential for benefitting patients if performed responsibly and in a culturally relevant manner. Our purpose was to assess the efficacy of small talks or “charlas” in promoting knowledge of prenatal vitamins in underserved Dominican women. STUDY DESIGN: We recruited patients seeking care at the Universidad Catolica Nordestana (UCNE) /University of Florida (UF) medical mission in San Francisco de Macorís in the Dominican Republic. Female subjects between the age of 18 and 50 gave verbal consent to participate in the study. The patients’ baseline preconceptional knowledge was assessed, after which they were provided a brief culturally engaging educational session known as a charla. A post assessment was performed. Women were stratified based on educational level (less than 5th grade education, 5th to 8th grade education, high school or university education). Comparisons between groups were made using Chi square and Fisher’s exact tests where appropriate. RESULTS: Seventy three women participated with educational levels: < 5th grade (n¼13), 5th to 8th grade (n¼24), high school (n¼22), university (n¼14). Knowledge that prenatal vitamins could help prevent birth defects differed among groups with affirmative answers in 34%, 54%, 59% and 86% of those with educational experience less than 5th grade, 5th to 8th grade, high school and university groups, respectively (p¼0.04). After completing the charla, the vast majority recognized the benefits of prenatal vitamins and differences no longer existed between the groups (p ¼ 0.47). Correspondingly, knowledge of when to initiate these vitamins was lacking amongst all groups (range 25% to 43% of women). Charlas demonstrated statistically significant improvements regarding the appropriate timing
OBJECTIVE: To examine obstetric and childhood outcomes of pregnancies with fetal mosaic trisomy 16 (MT16) or confined placental mosaicism (CPM) of T16. As T16 is potentially detectable by cell free DNA screening, a more thorough understanding of outcomes is essential for both management and counseling. STUDY DESIGN: In this cross-sectional survey study, we recruited participants through the Disorders of Chromosome 16 Foundation, an international organization including parents of children with chromosome 16 aberrations. Interviews were conducted with parents of children with MT16 or CPM based on chorionic villus sampling, amniocentesis, and/or postnatal testing. Information was gathered about diagnosis, expectations based on prenatal counseling, obstetric and neonatal course, and neurodevelopmental outcomes. Physical, emotional, social, and school functioning for each child was evaluated via the Pediatric Quality of Life Inventory version 4.0. RESULTS: Parents of 35 MT16 and CPM cases were interviewed. The median age of children was 5.3 years (0.75-19.3y), median maternal age at birth was 34y (28-41y), and 70.3% of children were female. Obstetric and childhood outcomes are described in the table. Parents expected poor outcomes based on prenatal counseling, including a median of 3.5 for learning capability on a scale of 1-10 (1 being worst imaginable outcome), 3 for chronic medical issues, and 4.5 for major birth defects. In contrast, 76.9% of school age children were entirely in mainstream classes, and 96.0% were at the appropriate grade level. Further, median physical and psychosocial function scores were high: 89 (50-100) and 85 (43-100), respectively (100 being optimal functioning). CONCLUSION: Preterm birth, hypertension, SGA, and cesarean delivery are common with both MT16 and CPM. While some congenital anomalies are prevalent, the vast majority of children have normal neurodevelopmental outcomes, including school performance as well as physical and psychosocial quality of life.
Supplement to JANUARY 2016 American Journal of Obstetrics & Gynecology
S319