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Obstetric Quality and Safety

Poster Session 1

(321) Alloimmunization in pregnancy: Patient-reported quality of care, mental health effects, and impact upon daily life

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: The objective of this study was to examine the perceived quality of care and impact upon mental health and daily living in pregnancies complicated by red blood cell alloimmunization.

Study Design: This investigation was an IRB-approved structured survey of individuals reporting a history of alloimmunization in pregnancy. Recruitment took place November 2022 to February 2023 through Allo Hope Foundation’s social media channels and private patient support group. In addition to inquiring about disease presentation, management and outcomes, respondents were asked about their perceived quality of care and the impact of their condition on their mental health and daily lives.

Results: 127 respondents detailing 200 pregnancies reported new or worsening feelings of anxiety (91%), guilt (75%), self-doubt (68%), isolation (71%), depression (68%) and symptoms of PTSD (61%) during their pregnancies. When asked to rate the quality of care they received during their pregnancies, individuals who rated their care as 8/10 or above reported significantly lower rates of guilt (p=0.004), self-doubt (p=0.003), depression (p=0.011), and symptoms of PTSD (p=0.006) compared to those with quality care ratings of 7/10 or below. Respondents were offered mental health support in 25% of alloimmunized pregnancies. Respondents were satisfied with the continuity of care across providers in 40% of pregnancies, with 37% and 67% reporting satisfaction with obstetrician/midwife and maternal fetal medicine specialist knowledge of alloimmunization respectively. 53% of respondents reported changing doctors to find better care. Self-reported impact upon daily living is depicted in the Figure.

Conclusion: Alloimmunization imposes a high emotional burden on patients. The obstetric and high-risk fetal medicine community must turn its attention to offering mental health support and bolstering its understanding of this complicated disease to minimize the patient burden.