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J Pediatr. 2016 Nov;178:130-134.e7. doi: 10.1016/j.jpeds.2016.08.006. Epub 2016 Sep 2.

Personalized Antenatal Consultations for Preterm Labor: Responding to Mothers' Expectations.

Author information

1
Division of Pediatric Emergency Medicine, CHU Sainte-Justine, University of Montreal, Montreal, Canada; Clinical Ethics' Unit, CHU Sainte-Justine, University of Montreal, Montreal, Canada; CHU Sainte-Justine Research Center, Department of Pediatrics, University of Montreal, Montreal, Canada. Electronic address: nathalie.orr.gaucher@umontreal.ca.
2
Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire de Québec, Centre Mère Enfant Soleil, Université Laval, Quebec, Canada.
3
Division of Neonatology, Department of Pediatrics, McGill University Health Center, McGill University, Montreal, Canada.
4
Clinical Ethics' Unit, CHU Sainte-Justine, University of Montreal, Montreal, Canada; CHU Sainte-Justine Research Center, Department of Pediatrics, University of Montreal, Montreal, Canada; Division of Neonatology, CHU Sainte-Justine, University of Montreal, Montreal, Canada; Palliative Care Unit, CHU Sainte-Justine, Montreal, Canada.

Abstract

OBJECTIVE:

To explore prospective mothers' perspectives regarding antenatal consultations by neonatology teams for threatened preterm delivery.

STUDY DESIGN:

In a prospective multicenter study, women at risk of preterm delivery between 26 and 32 weeks of gestational age were surveyed during the 72 hours following their antenatal consultation. The questionnaire used was developed and validated during a single-center study.

RESULTS:

Over 18 months, 229 mothers completed the survey (73% response rate), at a median gestational age of 30 weeks. Spouses/partners were present for 49% of consultations. Most women (90%) reported a positive experience. They found it important to discuss the outcomes of prematurity (96%), but 39% of them reported receiving too much information. Women wanted their spouse/partner to be present (71%) and wished to discuss parental concerns: their roles as mother of a premature baby (82%), their integration in their baby's care (83%), and a better understanding of the neonatal intensive care unit (NICU) environment, including antenatal NICU visits (69%). The majority (56%) wanted a follow-up consultation: this was less likely if a NICU visit had been offered (P < .001), if their role as decision-maker had been discussed (P < .05), or if the consultation had lasted longer (P = .001).

CONCLUSION:

Policy statements recommend a standardized approach to providing parents with child-centered information. Although clinicians follow these guidelines, mothers want personalized information focusing on their individual concerns and questions, such as what they can do for their baby, how NICUs work, and the integration of their family.

KEYWORDS:

NICU; antenatal consultation; bioethics; family-centered care; informed consent; maternal perspectives; neonatology; prematurity; preterm labor

PMID:
27597734
DOI:
10.1016/j.jpeds.2016.08.006
[Indexed for MEDLINE]

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