1043. Educational interventions increase Hepatitis C virus ( HCV) screening among pregnant women in inner city hospital
Session: Poster Abstract Session: Hepatitis Viruses
Friday, October 9, 2015
Room: Poster Hall
Background: The American College of Obstetricians and Gynecologists (ACOG) recommends risk based screening for Hepatitis C (HCV) testing of pregnant women.  Despite this, many remain unscreened. In 2005, our Pediatric Infectious Disease Service (PIDS) implemented an educational program to enhance awareness among health care providers regarding risk factors and the importance of screening pregnant women for HCV. The objectives of this study were to determine the effect of our educational program on screening practices in pregnant women as well as on the incidence of HCV in this high risk population

Methods: This study consists of a single arm pre-test / post-test design. In 1999, our institution went to an electronic medical record (EMR; Epic Systems, Madison, Wis.).  All women who delivered from 1/01/2000 to 12/31/2013 and who underwent screening for HCV during their pregnancy were identified via their EMR. For incidence rates, women diagnosed prior to 2000 were excluded. The educational intervention was initiated in 2005 with a pre-test period (1/01/2000 to 12/31/2005) and a post-test period (1/01/2006 to 12/31/2013).  The EMRs of all HCV women diagnosed in this time period were reviewed for HCV risk factors and demographics. 

Results: Two hundred and 30 women were diagnosed as having HCV in this 13 year period (pre-test n=88; post-test n=142).  In comparing the two time periods, the percent tested, incidence and prevalence rates all increased in the post-test period (8.3% vs. 6.4%, 4.8/1000 vs. 3.4/1000, and 5.9/1000 vs. 4.3/1000 deliveries, respectively, P < 0.05).  HCV pregant women in the post-test versus the pre-test period were younger (28.5 +/- 5.2 vs. 31.6 +/- 6.6), lower parity 1.9 +/- 1.7 vs. 2.6 +/- 2.6, Caucasian (81% vs. 53%), and had less hepatitis B (3% vs. 13%) and syphilis (0% vs. 6), P < 0.05.

Conclusion: This educational program resulted in an increase in testing rates which may have led to an increase in incidence and prevalence rates.  Demographics and risk factors for HCV also changed during the 2 time periods (post-test: younger, Caucasian, less Hepatitis B and syphilis).  Until there is universal screening for HCV, educational programs can improve screening rates. In addition, as populations change one needs to adjust the screening program on the evolving risk factors of one’s population.

Nitin Kumar, MD1, Dennis Super, MD1, Amy Edwards, MD2, Marwan Ali, B.S.3 and Nazha Abughali, MD1, (1)Pediatrics, MetroHealth Medical Center, Cleveland, OH, (2)Pediatric Infectious Diseases, Rainbow Babies and Children's Hospital, Cleveland, OH, (3)North East Ohio College of Medicine, north olmsted, OH

Disclosures:

N. Kumar, None

D. Super, None

A. Edwards, None

M. Ali, None

N. Abughali, None

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