W7.2 Women's experiences of pre-eclampsia: Australian action on pre-eclampsia survey of women and their confidants

We conducted a cross-sectional internet-based survey of users of the Preeclampsia Foundation website to assess participants’ knowledge of preeclampsia warning signs, use of prenatal care, and preeclampsia education offered by prenatal care providers. The data set represents 754 first pregnancies between 2000 and 2008. This self-selected sample represents all regions of the US, but disproportionately represented well-educated women (64.9% had at least a college education) with moderate/high incomes (74.0% reported incomes ≥$50,000/year). Most had a hypertensive disease of pregnancy (50.6% preeclampsia, 3.8% eclampsia, 15.1% HELLP syndrome, and 20.7% gestational hypertension) and nearly all reported receipt of regular prenatal care. Although most women reported that their providers regularly checked their blood pressure and collected urine samples, just 41.8% had the signs and symptoms of preeclampsia described to them by their provider; of those, about half said they fully understood the explanation. Less than one-third reported that their provider repeated the explanation of preeclampsia at a subsequent visit. Of those who said they definitely received information on the signs and symptoms of preeclampsia (315), 177 (56.2%) stated that this knowledge caused them to report symptoms, 66 (21.0%) went to the hospital because of symptoms, 115 (36.5%) monitored their own blood pressure, and 136 (43.2%) complied with an order of bedrest. Other sources of information about preeclampsia included family members, friends, and work colleagues. This study indicates that even well-educated, high-income women receiving prenatal care, fewer than half learned about the signs and symptoms of preeclampsia or other hypertensive disease of pregnancy from their prenatal care provider. Although limitations of this study include self-sampling and a non-representative proportion of well-educated women, it should also be noted that based on reporting of their own diagnoses, they were nearly all at elevated risk. More deliberate, detailed, and repeated explanations of preeclampsia, including warning signs and symptoms, should be included during prenatal visits for all pregnant women.