Pregnancy complications and loss: an observational survey comparing anesthesiologists and obstetrician–gynecologists

Figures & data

Figure 1. Consort diagram.

Table 1. Participant characteristics by provider type.

	Anesthesia (N = 224)	OB/GYN (N = 168)	p
Age at time of survey, N (%)			.517
25–30 years old	2 (0.89)	6 (3.57)
31–35 years old	48 (21.4)	39 (23.2)
36–40 years old	51 (22.8)	40 (23.8)
41–45 years old	54 (24.1)	15 (8.93)
46–50 years old	24 (10.7)	16 (9.52)
51–55 years old	13 (5.80)	19 (11.3)
56–60 years old	9 (4.02)	16 (9.52)
>61 years old	23 (10.3)	17 (10.1)
Race, N (%)			.861
White	177 (79.0)	130 (77.4)
Black	5 (2.23)	6 (3.57)
Asian	21 (9.38)	19 (11.3)
Other	11 (4.91)	7 (4.17)
Not answered	10 (4.46)	6 (3.57)
Hispanic ethnicity, yes, N (%)	8 (3.57)	10 (5.95)	.230
Years in practice (including residency), N (%)a			.046
0–5 years	18 (8.07)	17 (10.1)
6–10 years	72 (32.3)	45 (26.8)
11–15 years	49 (22.0)	34 (20.2)
16–20 years	40 (17.9)	12 (7.14)
21–25 years	10 (4.48)	16 (9.52)
>25 years	34 (15.2)	44 (26.2)
How would you describe your practice? N (%)			<.001
Academic	218 (97.3)	131 (78.0)
Private	2 (0.89)	32 (19.1)
Per diem/other	3 (1.34)	5 (2.98)
What percentage of your cases do you supervise residents/CRNAs/AAs/NPs/PAs? N (%)^a			<.001
0–25%	12 (5.41)	34 (20.2)
26–50%	27 (12.2)	16 (9.52)
51–75%	30 (13.5)	22 (13.1)
>75%	150 (67.6)	83 (49.4)
Do not supervise	3 (1.35)	13 (7.74)
What percentage of your attending colleagues are female? N (%)^a			<.001
0–25%	14 (6.33)	5 (3.01)
26–50%	161 (72.8)	4 (2.41)
51–75%	45 (20.4)	80 (48.2)
>75%	1 (0.45)	77 (46.4)
Do you recall learning about potential risks to pregnancy related to your specialty? Yes, N (%)^a	121 (54.3)	40 (24.0)	<.001
If Yes, where, N (%)
Grand rounds	30 (24.8)	25 (62.5)	<.001
Institutional training	34 (28.1)	18 (45.0)	.074
Informal conversation	71 (58.7)	19 (47.5)	.169
Self-research	58 (47.9)	26 (65.0)	.091
Do not recall	27 (22.3)	1 (2.50)	.003
Are you aware of a policy at your institution for support for pregnant employees? Yes, N (%)	90 (40.2)	42 (25.0)	.007
Are you aware of a policy at your institution for education on specialty related risks for pregnant employees? Yes, N (%)	20 (8.93)	7 (4.17)	.180
Are you currently using or have you ever used reproductive assistance? Yes, N (%)	26 (11.61)	47 (27.98)	<.001
Type of assistance, N (%)
Oral medication	9 (34.6)	19 (40.4)	.812
In vitro fertilization	13 (50.0)	24 (51.1)	1.000
IUI	12 (46.2)	19 (40.4)	.821
Surrogacy	0 (0.00)	1 (2.13)	1.000
Other	3 (11.5)	11 (23.4)	.352
Rounds oral medication, median (IQR; range)	2.5 (1.25; 1–7)	3.0 (3.75; 1–10)	.648
Rounds in vitro, median (IQR; range)	2 (3; 1–7)	2 (2; 1–9)	.408
Rounds IUI, median (IQR; range)	2 (1.25; 1–6)	2 (2; 1–12)	.913
Have you ever been pregnant, yes, N (%)	103 (45.98)	116 (69.05)	<.001

^a Between 1 and 5 providers did not provide a response to this question.

Table 2. Characteristics of those reporting at least one pregnancy by provider type.

	Anesthesia (N = 103)	OBGYN (N = 116)	p
Gravidity, median (IQR; range)	3 (1.5; 1–7)	2 (2; 1–10)	.008
Parity, median (IQR; range)	2 (1; 0–4)	2 (1; 0–7)	<.001
Any complications or loss, yes, N (%)	67 (65.1)	76 (65.5)	.942
# Complications/losses, median (IQR; range)	1 (2; 0–6)	1 (2; 0–6)	.597
Age at first pregnancy, N (%)			.453
15–20	0 (0.00)	1 (0.86)
21–25	6 (5.83)	3 (2.58)
26–30	34 (33.0)	32 (27.6)
31–35	52 (50.5)	62 (53.4)
36–40	11 (10.7)	16 (13.8)
40–45	0 (0.00)	2 (1.72)
Training at time of pregnancy, N (%)			.043
Pre-residency	12 (11.7)	6 (5.17)
Residency	42 (40.8)	34 (29.3)
Fellowship	8 (7.77)	19 (16.4)
Attending	40 (38.8)	55 (47.4)
Other	1 (0.97)	2 (1.72)
Type of complication, yes, N (%)
Subchorionic hematoma	6 (5.83)	10 (8.62)	.451
Placental abruption	5 (4.85)	5 (4.31)	1.000
Preeclampsia	8 (7.77)	11 (9.48)	.811
Preterm labor	19 (18.4)	15 (12.9)	.270
Preterm membrane rupture	8 (7.77)	7 (6.03)	.790
Pregnancy loss ever	37 (35.9)	28 (24.1)	.057
Other complication	21 (20.4)	30 (25.9)	.423
# Losses, median (IQR; range)	0 (1; 0–5)	0 (0; 0–4)	.146
# Losses among those with at least 1 loss, median (IQR; range)	1 (1; 1–5)	2 (2; 1–4)	.145
Congenital abnormality? Yes, N (%)^a	7 (6.93)	6 (5.31)	.620
Genetic syndrome? Yes, N (%)^a	7 (6.80)	5 (4.50)	.559
Premature baby? Yes, N (%)^a	22 (21.4)	23 (20.0)	.805
NICU stay? Yes, N (%)^a	22 (21.6)	22 (19.3)	.679

^a Between 1 and 5 providers did not provide a response to this question.

Table 3. Experience among those who experienced a complication at work.

	Anesthesia (N = 67)	OBGYN (N = 76)	p
Did you experience the complication while at work? Yes, N (%)	38 (56.7)	41 (53.9)	.87
If the complication happened at work:
Did you alert your employer of the complication? Yes, N (%)	29 (76.3)	28 (68.3)	.427
Was your supervisor at the time male or female? Male, N (%)^a	30 (85.7)	17 (41.5)	<.001
Were you able to leave and seek medical care? Yes, N (%)b	24 (80.0)	30 (90.9)	.289
Did you request a leave of absence for this complication? Yes, N (%)c	21 (33.3)	26 (36.1)	.735

^a Three anesthesia providers who experienced a complication at work did not answer this question.

^b Eight anesthesia providers and eight OBGYN providers who experienced a complication at work did not answer this question.

^c Four anesthesia providers and four OBGYN providers who experienced a complication did not answer this question.

Data availability statement

The data that support the findings of this survey study are available upon request from the corresponding author, NRB. The data are not publicly available due to the sensitive nature of the study and concerns for the privacy of research participants.