{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:22:36Z","timestamp":1790792556980,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,12,29]],"date-time":"2019-12-29T00:00:00Z","timestamp":1577577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe spontaneous preterm birth prevention practices self\u2010reported before and after the dissemination of relevant guidelines, and to identify personal and organisational factors associated with adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A repeated cross\u2010sectional vignette\u2010based survey study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>French obstetricians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>French obstetricians practicing in public or private maternity units.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Before and after the dissemination of the 2017 French guidelines on the prevention of spontaneous preterm birth, participants were asked to complete a web\u2010based self\u2010administered questionnaire based on two clinical vignettes. Vignette 1 focused on respondents\u2019 attitudes towards strict bed rest, cerclage, and progesterone treatment for women with a short cervix in mid\u2010trimester; vignette 2 focused on attitudes towards strict bed rest and maintenance tocolysis after successful tocolysis for preterm labour. A mixed quantitative and qualitative analysis was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Non\u2010adherence to guidelines for the prevention of spontaneous preterm birth in responses to each vignette.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We obtained complete responses from 286 obstetricians before and 282 obstetricians after guideline dissemination, including 145 obstetricians participating in both. After dissemination, 51.4% of obstetricians self\u2010reported non\u2010adherent practices for vignette 1 and 22.3% of obstetricians self\u2010reported non\u2010adherent practices for vignette 2. No improvement was observed after dissemination. The quantitative analysis identified factors associated with non\u2010adherence, including older age and practice in non\u2010university or small hospitals, whereas the qualitative analysis highlighted barriers to implementation, including fear of change, habits, work overload, and lack of time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adherence to guidelines was generally low, with practices unmodified by their dissemination. Improvement is required, especially regarding applicability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Adherence to guidelines to prevent spontaneous preterm birth was generally low and remained unmodified after guideline dissemination.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16039","type":"journal-article","created":{"date-parts":[[2019,12,5]],"date-time":"2019-12-05T10:29:42Z","timestamp":1575541782000},"page":"467-476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Do obstetricians apply the national guidelines? A vignette\u2010based study assessing practices for the prevention of preterm birth"],"prefix":"10.1111","volume":"127","author":[{"given":"A","family":"Rousseau","sequence":"first","affiliation":[{"name":"Midwifery Department Versailles Saint Quentin University Montigny\u2010le\u2010Bretonneux France"},{"name":"EA 7285 Versailles Saint Quentin University Montigny le Bretonneux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Azria","sequence":"additional","affiliation":[{"name":"Maternity Unit Notre Dame de Bon Secours Paris Saint Joseph Hospital Paris Descartes University Paris France"},{"name":"National Institute for Health and Medical Research (INSERM) Unit 1153 Obstetrical Perinatal and Paediatric Epidemiology Research Team (EPOP\u00e9) Center for Epidemiology and Statistics Sorbonne Paris Cit\u00e9 DHU Risks in Pregnancy Paris University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Baumann","sequence":"additional","affiliation":[{"name":"Midwifery Department Versailles Saint Quentin University Montigny\u2010le\u2010Bretonneux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3321","authenticated-orcid":false,"given":"C","family":"Deneux\u2010Tharaux","sequence":"additional","affiliation":[{"name":"National Institute for Health and Medical Research (INSERM) Unit 1153 Obstetrical Perinatal and Paediatric Epidemiology Research Team (EPOP\u00e9) Center for Epidemiology and Statistics Sorbonne Paris Cit\u00e9 DHU Risks in Pregnancy Paris University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MV","family":"Senat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Bic\u00eatre Hospital AP\u2010HP Kremlin Bic\u00eatre France"},{"name":"Paris Sud Paris Saclay University Le Kremlin Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.15.1458"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0152863"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.respe.2012.03.002"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001564"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.08.005"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-007047"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14838"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000236434.74160.8b"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14546-1"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-10-64"},{"issue":"3","key":"e_1_2_6_12_1","first-page":"S207","article-title":"Combined quantitative and qualitative methods to identify local facilitators of and barriers to physician\u2019s adherence to clinical practice guidelines","volume":"56","author":"Saillour\u2010Gl\u00e9nisson F","year":"2008","journal-title":"Rev Epidemiol Sante Publique"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281334"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61856-X"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0050788"},{"key":"e_1_2_6_16_1","first-page":"1861","article-title":"Assessment of adherence to guidelines for using progesterone to prevent recurrent preterm birth","volume":"29","author":"Crane SS","year":"2016","journal-title":"J Matern\u2010Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001711"},{"key":"e_1_2_6_18_1","volume-title":"Preterm labour and birth|Guidance and guidelines|NICE (Internet)"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15173"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.12.035"},{"key":"e_1_2_6_21_1","volume-title":"Les recommandations pour la pratique clinique","author":"Haute Autorit\u00e9 de Sant\u00e9 (HAS)"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgyn.2016.09.015"},{"key":"e_1_2_6_23_1","unstructured":"DRESS.D\u00e9mographie des m\u00e9decins (RPPS) (Internet)[Internet]. 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