729 - Experience is Not Enough: Prior Preterm Birth, Anxiety, and Knowledge Among Pregnant Women at Risk for Preterm Delivery

Publication Number: 1706.729

Siobhan M. McDonnell, Medical College of Wisconsin, Willmar, MN, United States; Kathryn E. Flynn, Medical College of Wisconsin, Milwaukee, WI, United States; Sheikh Iqbal Ahamed, Marquette University, Milwaukee, WI, United States; Abbey Kruper, Medical College of Wisconsin, Milwaukee, WI, United States; Mir A Basir, Medical College of Wisconsin, Brookfield, WI, United States

Background: Women with a history of premature birth are at increased risk of delivering prematurely in subsequent pregnancies. Studies show that these women are anxious about reoccurrence or another adverse outcome. However, the impact of prior premature birth on maternal learning engagement and premature birth knowledge is unknown.

Objective: Evaluate the relationship between a prior premature birth, anxiety levels, and premature birth knowledge among pregnant women at risk of premature birth.

Design/Methods: This is an ancillary analysis of IRB-approved NCT04093492. Pregnant women with risk factors for premature birth, including prior premature birth, were randomized at 18-21 weeks gestational age (GA) to receive either the Preemie Prep for Parents (P3) program or a control. The P3 program sends periodic text messages with links 51 short, animated educational videos; software tracked video use. Assessments were collected at enrollment (PROMIS Anxiety) and at 25, 30, and 34 weeks GA (PROMIS Anxiety, Parent Prematurity Knowledge Questionnaire).

Results: Of 120 participants, 57 (48%) had history of premature birth (Table 1). Prior premature birth was not significantly associated with anxiety levels at any time point (Figure 1), nor was the GA of the prior premature birth significantly associated with baseline anxiety (p=0.09). Among those with prior premature birth, baseline anxiety did not predict knowledge at 25 (p=0.95), 30 (p=0.14), or 34 weeks (p=0.16). At 25 weeks, participants with a prior premature birth had lower knowledge scores than those without, p=0.009, but this difference was no longer significant at 30 (p=0.11) or 34 weeks (p=0.06), Figure 2. Mothers with a prior periviable birth (20-24 weeks GA) were no more likely to correctly identify neonatal resuscitation options at periviable birth (p=0.08). Within the P3 group (n=60), participants with a prior premature birth (n=20) viewed fewer videos (mean 42%) than those without such history (61%), p=0.04.

Conclusion(s): In this study, prior premature birth was not associated with elevated anxiety, possibly due to high-risk status of our entire sample. However, women with prior premature birth engaged less with educational content and initially showed less premature birth knowledge despite prior experience. These findings suggest that lived experience alone may not confer accurate understanding of premature birth and highlight the importance of tailored education for this population.

Table 1.
Table 1_.pdfFrequency and anxiety levels by gestational age of prior premature birth.

Figure 1.
Figure 1_.pdfPROMIS Anxiety at baseline, 25 weeks, 30 weeks, and 34 weeks, by whether the participant had a prior premature birth.

Figure 2.
Figure 2_.pdfParent Prematurity Knowledge Questionnaire scores, as percentage correct, by follow up assessment and whether the participant had a prior premature birth.