Premium
Perspectives on periviability counselling and decision‐making differed between neonatologists in the United States and the Netherlands
Author(s) -
Schrijvers Ninke M.,
Geurtzen Rosa,
Draaisma Jos M.T.,
Halamek Louis P.,
Yamada Nicole K.,
Hogeveen Marije
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14347
Subject(s) - medicine , intensive care , gestation , family medicine , neonatology , resuscitation , prenatal care , pediatrics , emergency medicine , pregnancy , intensive care medicine , environmental health , population , genetics , biology
Aim American guidelines suggest that neonatal resuscitation be considered at 23 weeks of gestation, one week earlier than in the Netherlands, but how counselling practices differ at the threshold of viability is unknown. This pilot study compared prenatal periviability counselling in the two countries. Methods In 2013, a cross‐sectional survey was sent to 121 Dutch neonatologists as part of a nationwide evaluation of prenatal counselling. In this pilot study, the same survey was sent to a convenience sample of 31 American neonatologists in 2014. The results were used to compare the organisation, content and decision‐making processes in prenatal counselling at 24 weeks of gestation between the two countries. Results The survey was completed by 17 (55%) American and 77 (64%) Dutch neonatologists. American neonatologists preferred to meet with parents more frequently, for longer periods of time, and to discuss more intensive care topics, including long‐term complications, than Dutch neonatologists. Neonatologists from both countries preferred shared decision‐making when deciding whether to initiate intensive care. Conclusion Neonatologists in the United States and the Netherlands differed in their approach to prenatal counselling at 24 weeks of gestation. Cross‐cultural differences may play a role.