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Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study

OBJECTIVE: Our main objective was to examine if parental prenatal preferences predict delivery-room management of extremely preterm periviable infants. The secondary objectives were to describe parental involvement and the content of prenatal counseling given to parents for this prenatal decision. D...

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Autores principales: Levaillant, Cerise, Caeymaex, Laurence, Béhal, Hélène, Kaminski, Monique, Diguisto, Caroline, Tosello, Barthélémy, Azria, Elie, Claris, Olivier, Bétrémieux, Pierre, Foix L’Hélias, Laurence, Truffert, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715208/
https://www.ncbi.nlm.nih.gov/pubmed/31465428
http://dx.doi.org/10.1371/journal.pone.0221859
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author Levaillant, Cerise
Caeymaex, Laurence
Béhal, Hélène
Kaminski, Monique
Diguisto, Caroline
Tosello, Barthélémy
Azria, Elie
Claris, Olivier
Bétrémieux, Pierre
Foix L’Hélias, Laurence
Truffert, Patrick
author_facet Levaillant, Cerise
Caeymaex, Laurence
Béhal, Hélène
Kaminski, Monique
Diguisto, Caroline
Tosello, Barthélémy
Azria, Elie
Claris, Olivier
Bétrémieux, Pierre
Foix L’Hélias, Laurence
Truffert, Patrick
author_sort Levaillant, Cerise
collection PubMed
description OBJECTIVE: Our main objective was to examine if parental prenatal preferences predict delivery-room management of extremely preterm periviable infants. The secondary objectives were to describe parental involvement and the content of prenatal counseling given to parents for this prenatal decision. DESIGN: Prospective study of neonates liveborn between 22 and 26 weeks of gestation in France in 2011 among the neonates included in the EPIPAGE-2 study SETTING: 18 centers participating in the “Extreme Prematurity Group” substudy of the EPIPAGE-2 study. PATIENTS: 302 neonates liveborn between 22–26 weeks among which 113 with known parental preferences while parental preferences were unknown or unavailable for 186 and delivery room management was missing for 3. RESULTS: Data on prenatal counseling and parental preferences were collected by a questionnaire completed by professionals who cared for the baby at birth; delivery room (DR) management, classified as stabilization or initiation of resuscitation (SIR) vs comfort care (CC). The 113 neonates studied had a mean (SD) gestational age of 24 (0.1) weeks. Parents of neonates in the CC group preferred SIR less frequently than those with neonates in the SIR group (16% vs 88%, p < .001). After multivariate analysis, preference for SIR was an independent factor associated with this management. Professionals qualified decisions as shared (81%), exclusively medical (16%) or parental (3%). Information was described as medical with no personal opinion (71%), complete (75%) and generally pessimistic (54%). CONCLUSION: Parental involvement in prenatal decision-making did not reach satisfying rates in the studied setting. When available, prenatal parental preference was a determining factor for DR management of extremely preterm neonates. Potential biases in the content of prenatal counselling given to parents need to be evaluated.
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spelling pubmed-67152082019-09-10 Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study Levaillant, Cerise Caeymaex, Laurence Béhal, Hélène Kaminski, Monique Diguisto, Caroline Tosello, Barthélémy Azria, Elie Claris, Olivier Bétrémieux, Pierre Foix L’Hélias, Laurence Truffert, Patrick PLoS One Research Article OBJECTIVE: Our main objective was to examine if parental prenatal preferences predict delivery-room management of extremely preterm periviable infants. The secondary objectives were to describe parental involvement and the content of prenatal counseling given to parents for this prenatal decision. DESIGN: Prospective study of neonates liveborn between 22 and 26 weeks of gestation in France in 2011 among the neonates included in the EPIPAGE-2 study SETTING: 18 centers participating in the “Extreme Prematurity Group” substudy of the EPIPAGE-2 study. PATIENTS: 302 neonates liveborn between 22–26 weeks among which 113 with known parental preferences while parental preferences were unknown or unavailable for 186 and delivery room management was missing for 3. RESULTS: Data on prenatal counseling and parental preferences were collected by a questionnaire completed by professionals who cared for the baby at birth; delivery room (DR) management, classified as stabilization or initiation of resuscitation (SIR) vs comfort care (CC). The 113 neonates studied had a mean (SD) gestational age of 24 (0.1) weeks. Parents of neonates in the CC group preferred SIR less frequently than those with neonates in the SIR group (16% vs 88%, p < .001). After multivariate analysis, preference for SIR was an independent factor associated with this management. Professionals qualified decisions as shared (81%), exclusively medical (16%) or parental (3%). Information was described as medical with no personal opinion (71%), complete (75%) and generally pessimistic (54%). CONCLUSION: Parental involvement in prenatal decision-making did not reach satisfying rates in the studied setting. When available, prenatal parental preference was a determining factor for DR management of extremely preterm neonates. Potential biases in the content of prenatal counselling given to parents need to be evaluated. Public Library of Science 2019-08-29 /pmc/articles/PMC6715208/ /pubmed/31465428 http://dx.doi.org/10.1371/journal.pone.0221859 Text en © 2019 Levaillant et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Levaillant, Cerise
Caeymaex, Laurence
Béhal, Hélène
Kaminski, Monique
Diguisto, Caroline
Tosello, Barthélémy
Azria, Elie
Claris, Olivier
Bétrémieux, Pierre
Foix L’Hélias, Laurence
Truffert, Patrick
Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study
title Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study
title_full Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study
title_fullStr Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study
title_full_unstemmed Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study
title_short Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study
title_sort prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in france - the epipage-2 cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715208/
https://www.ncbi.nlm.nih.gov/pubmed/31465428
http://dx.doi.org/10.1371/journal.pone.0221859
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