829 Utility of qualitative research for assessment of attitudes and knowledge on preterm birth in a low resource setting Judy Levison 1 , Debora Nanthuru 3 , Grace Chiudzu 2 , Peter Kazembe 3 , Henri Phiri 2 , Kjersti Aagaard 1 1 Baylor College of Medicine, Obstetrics&Gynecology, Houston, TX, 2 Kamuzu Central Hospital, Obstetrics&Gynecology, Lilongwe, Malawi, 3 Kamuzu Central Hospital, Children’s Clinical Center of Excellence, Lilongwe, Malawi OBJECTIVE: Malawi has one of the highest preterm birth (PTB) rates in the world at 20.3%. At the start of a funded initiative in the largest populated district (Lilongwe), we sought to complete a needs assess- ment and gap analyses employing validated qualtitative field research methodologies in order to focus potential high-impact interventions. STUDY DESIGN: In mentored partnership with regional providers 14 and 50 km from the central referral hospital, investigative teams com- prised of clinician investigators, data recorder, and interpreters held focus groups for voluntary participants (n=28) of community health workers (CHWs), patient couples, midwives and clinical officers. Di- rected, non-directed, structured and unstructured questions facili- tated PTB discussion, including definitions, perception, causation, management, and accepted interventions. RESULTS: Robust discussion occurred in all groups. Among patient couples, a total of 162 questions were asked with 298 answers given (1:1.84), the majority answered by women (55.6%-87.6%). No knowledge gap was observed for accepted dating and length of gesta- tion, biologic causation of PTB, and presumptive benefit of antenatal care, nutrition, and optimized maternal health. Generalized concen- sus among all groups defined the threshold of viability by gestational age at 26-28 weeks, which was discordant with similarly defined birth- weight threshold at 1.4-1.9 kg. Knowledge and prevention-interven- tion gaps were uniformly observed among all participants regarding any prevention or intervention strategies, including antenatal corti- costeroids, prevention of recurrent PTB, PTB risk-managment and interventions, and referral service-line utilization. CONCLUSION: Qualitative research into community baseline gaps and needs is essential. Applied and informed dynamic education and knowledge dissemination, accepted prevention-intervention strate- gies, and inpatient and outpatient referral networks are under devel- opment as a result of this study. 830 Racial and ethnic differences in beliefs about exclusive breastfeeding Karen Hardy 1 , Alison Stuebe 2 , Beth Horton 3 , Kim Andringa 4 , Catherine Cunningham 5 , Kathleen Shapley-Quinn 5 1 University of North Carolina at Chapel Hill, African American Studies, Chapel Hill, NC, 2 UNC School of Medicine, Obstetrics and Gynecology, Chapel Hill, NC, 3 UNC Gillings School of Global Public Health, Biostatistics, Chapel Hill, NC, 4 University of North Carolina School of Medicine, Center for Women’s Health Research, Chapel Hill, NC, 5 Alamance County Health Department, Alamance County Health Department, Alamance, NC OBJECTIVE: Significant racial and ethnic disparities exist in exclusive breastfeeding rates. We sought to measure differences in beliefs about exclusive breastfeeding among women from different racial and eth- nic groups. STUDY DESIGN: Women eligible for WIC at a community health de- partment were enrolled in a longitudinal study. Participants com- pleted surveys during pregnancy and at 1, 3 and 6 months postpartum. We compared responses to the prenatal survey among non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic women. RESULTS: Of the 223 women who completed the prenatal survey, 97 were NHW, 62 were NHB, and 64 were Hispanic. More than 70% of participants believed that breastfed infants were less likely than for- mula-fed infants to get ear infections, colds or diarrhea. Hispanic women were more likely to have been breastfed themselves as infants (82.8%), compared with NHW (37.9%) or NHB (29.5%) women (p 0.01), and were more likely to have 3 or more friends or relatives who had breastfed. Multiparous Hispanic women were more likely to have previously breastfed (88.6% vs. 55.6%, p  0.01), and to have breastfed longer (median 12 months, IQR 3.5, 14) than NHW (me- dian 2 months, IQR 1.5, 6) or NHB women (median 3 months, IRQ 2.5, 5.5, p  .01). However, despite more experience with breastfeed- ing, Hispanic women were more likely to say that a mix of breast milk and formula was the best way to feed a baby (37.5%) than NHB (25.8%) or NHW women (14.6% p  .01). Hispanic women were also more likely than NHB or NHW women to rate their mother, mother- in-law, and sister or best friend’s opinion about infant feeding as very important, and to report that these individuals recommended breast- feeding or both breast and formula feeding, (Table, p  .01 for all comparisons). CONCLUSION: We found differences in both personal experience with breastfeeding and in the influence of social networks among Hispanic, NHW and NHB women. These results may inform strategies to re- duce racial and ethnic disparities in exclusive breastfeeding rates. 831 Maternal participation in prenatal screening among liveborn singletons with Down syndrome: patterns by disparity groupings and relationship with frequency of hospital transfer Laura Jelliffe 1 , Monica Flessel 1 , Rebecca Baer 1 , Ning Rosenthal 1 , Suzan Catmichael 2 , Shaw Gary 2 , Robert Currier 1 1 California Department of Public Health, Genetic Disease Screening Program, Richmond, CA, 2 Stanford University School of Medicine, Department of Pediatrics, Neonatal and Development Medicine, Palo Alto, CA OBJECTIVE: We examine the frequency of maternal participation in prenatal screening among liveborn singletons with Down syndrome by race/ethnicity, insurance coverage for prenatal care, and by urban versus rural county of residence groupings. In addition, we explore whether any differences might be associated with the frequency of hospital transfer. STUDY DESIGN: All Down syndrome cases with births in 2005-2008 reported to the California Genetic Disease Screening Program as part of routine collection of registry data (n = 1,714) with linked birth certificate and hospital discharge records were included. Data was used to compare the frequency of second trimester screening partici- pation among groups. Frequency of transfer from birth hospital was also compared for screened and non-screened pregnancies. Compar- isons were made using logistic regression methods (odds ratios (ORs) and 95% confidence intervals (CIs)). RESULTS: We found that participation in prenatal screening was sig- nificantly lower for mothers who reported their method of payment for prenatal care as “self-pay” or as “no insurance” compared to preg- nancies with “private insurance” (0% and 32.3% compared to 54.0%) and for mothers living in rural counties compared to urban counties The influence of family and close friends on feeding varies by race and ethnicity www.AJOG.org Clinical Ob, Epidemiology, ID, Intrapartum Fetal, Operative Ob, Med-Surg-Diseases, Ob Quality & Safety, Public & Global Health Poster Session V Supplement to JANUARY 2013 American Journal of Obstetrics & Gynecology S347