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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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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. |
format | Online Article Text |
id | pubmed-6715208 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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