KEYWORD1:
Perinatal screening, hepatitis B, rubella, varicella, standards of care, barriers to vaccination, assessments

BACKGROUND:
The CDC and ACOG have established standards of care for screening and treatment of rubella, hepatitis B and C, HIV, varicella, group B streptococcus and syphilis. Implementation of practices to meet the standards is essential for the prevention of congenital morbidity and mortality in newborns. The level of compliance with the standards in Philadelphia is unknown.

OBJECTIVE:
To assess the rates of compliance with current CDC/ACOG perinatal screening standards in Philadelphia, and identify potential barriers to implementation.

METHOD:
A sample of 600 patients representative of the 2000 Philadelphia birth cohort was selected. A total of 599 patient records were reviewed from the 15 birthing hospitals within Philadelphia. Data abstracted from the chart included maternal demographics, documentation of disease screening procedures, screening results, and treatment (where applicable). The data were analyzed to determine the rates of compliance with the accepted standard of care for prevention of the various diseases and patterns of services and documentation.

RESULT:
Rates of compliance for screening and treatment for each disease will be presented. Potential barriers to compliance and implications for perinatal prevention programs will be discussed.

CONCLUSION:
The type and thoroughness of documentation varied widely between hospitals. Rates of screening varied by disease. Non-standard and incomplete documentation hinders surveillance and QA efforts. Adoption of standard reporting forms could improve practice and aid in QA.

LEARNINGOBJECTIVES:
List the rates of compliance with established CDC/ACOG perinatal screening standards. Identify barriers to compliance. Discuss implications for perinatal disease prevention, particularly with regard to vaccine-preventable disease.