A scoping review of parental values during prenatal decisions about treatment options after extremely premature birth

Acta Paediatr. 2023 May;112(5):911-918. doi: 10.1111/apa.16690. Epub 2023 Feb 10.

Abstract

Aim: To describe what is known in the literature about parental perspectives in making prenatal decisions regarding treatment after birth at the limit of viability, as a better understanding of parental values can help professionals support parents as they decide.

Methods: PubMed, Cochrane, Embase, CINAHL, PsycINFO and Web of Science were searched to identify relevant literature from 1 January 2010 to 22 April 2022 on parental decision making. Data were extracted from selected studies and organised into themes. The final themes were formed through collaboration with the parents of a premature infant born at 24 weeks.

Results: Of the 15,159 papers examined, 17 were included. Parental perspectives were described in terms of long-term outcomes for the infant, survival, protection against the burden of neonatal treatment, long-term impact on the family, religion and spiritual beliefs, to do everything possible, hope, sense of responsibility, wanting the best, doing what is right, giving a chance and the influence of experience.

Conclusion: The extracted parental perspectives show the complexity of these decisions. Some perspectives were clear, but others were multi-interpretable. Increasing the understanding of common parental perspectives can help improve shared prenatal decisions and lead to further improvement and personalisation of the process.

Publication types

  • Review
  • Comment

MeSH terms

  • Decision Making
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Parents
  • Parturition
  • Pregnancy
  • Premature Birth* / therapy