COMPARISON OF PERCEIVED AND ACTUAL RATES OF SURVIVAL AND FREEDOM FROMHANDICAP IN PREMATURE-INFANTS

OBJECTIVE: Our goal was to learn whether physicians delivering obstetr ic care accurately estimated rates of survival and freedom from handic ap in premature infants. STUDY DESIGN: We surveyed by mail 409 obstetr icians and general and family physicians reported to perform deliverie s in Alabama to identify their perceptions regarding survival and hand icap-free rates of infants born at gestational ages between 23 and 36 weeks, inclusive. Responses were compared with published national rate s of survival and freedom from handicap by means of unpaired t tests. RESULTS: A total of 224 physicians responded (55%), and 183 were still practicing obstetrics. They significantly underestimated survival rat es from 23 through 34 weeks' gestation (p < 0.05) and freedom from ser ious handicap from 23 through 36 weeks' gestation Co < 0.05). They adv ocated early treatment of preterm labor, but < 50% would perform cesar ean delivery for fetal distress before 26 weeks' gestation. CONCLUSION : We conclude that physicians delivering obstetric care significantly underestimate survival and freedom from handicap in preterm infants. P erinatal care may be adversely affected by these misperceptions.