Premium
What are we telling the parents of extremely preterm babies?
Author(s) -
Boland Rosemarie Anne,
Davis Peter Graham,
Dawson Jennifer Anne,
Doyle Lex William
Publication year - 2016
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12448
Subject(s) - psychology , developmental psychology , pediatrics , medicine
Background Parent counselling and decision‐making regarding the management of preterm labour and birth are influenced by information provided by healthcare professionals regarding potential infant outcomes. Aim The aim of this study was to determine whether perinatal healthcare providers had accurate perceptions of survival and major neurosensory disability rates of very preterm infants born in non‐tertiary hospitals (‘outborn’) and tertiary perinatal centres (‘inborn’). Materials and Methods A web‐based survey was distributed to midwives, nurses, obstetricians and neonatologists working in non‐tertiary and tertiary maternity hospitals, and the perinatal/neonatal emergency transport services in Victoria, Australia. Main outcome measures Estimates of survival rates at 24 and 28‐weeks' gestation were compared with actual survival rates of a population‐based cohort of 24 and 28‐weeks' gestation infants, born free of lethal anomalies in Victoria in 2001–2009. Estimates of major neurosensory disability rates in 24 and 28‐week survivors were compared with actual disability rates in 24 and 28‐week children born in Victoria averaged over three eras: 1991–1992, 1997 and 2005. Results Response rates varied as follows: 83% of non‐tertiary midwives, 4% of obstetricians, 55% of tertiary centre staff and 68% of transport team staff responded (total of 30%). Overall, respondents underestimated survival and overestimated major neurosensory disability rates in both outborn and inborn 24 and 28‐week infants. Outborn infants were perceived to have much worse prospects for survival and for survival with major disability compared with inborn peers. Conclusion Many clinicians overestimated rates of adverse outcomes. These clinicians may be misinforming parents about their child's potential for a favourable outcome.