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Treatment of extremely preterm infants: parents' attitudes
B Mølholm Hansen1, B Hoff, G Greisen
1Department of Neonatology, Rigshospitalet, Copenhagen, Denmark. moelholm@dadlnet.dk
Insights
Parents of extremely preterm infants share similar views on life-saving treatment as the general population. Their attitudes are influenced by potential handicaps and parental preferences, not a more conservative stance.
Area of Science:
- Neonatalogy
- Pediatric Ethics
- Public Health
Background:
- Extremely preterm infants (born <28 weeks gestation or <1000g) present complex treatment decisions.
- Understanding parental attitudes towards life-saving interventions is crucial for ethical care.
- Previous research has not extensively compared these attitudes between parents of preterm infants and the general population.
Purpose of the Study:
- To survey and compare attitudes towards life-saving treatment for extremely preterm infants.
- To investigate the perceived importance of parental preferences in treatment decisions.
- To compare attitudes between parents of extremely preterm children and the general population.
Main Methods:
- A Danish national cohort study assessed children born 1994-1995 (extremely preterm and term controls).
- Parents responded to a questionnaire with case vignettes depicting clinical scenarios.
- Response rates exceeded 76% for both index and reference groups.
Main Results:
- Both groups supported life-saving treatment for extremely preterm infants.
- Recommendations were significantly influenced by the child's risk of handicap and parental preferences.
- Parents of extremely preterm children did not exhibit a more conservative attitude than the general population.
Conclusions:
- Attitudes towards life-saving treatment for extremely preterm infants are comparable between parents of these children and the general population.
- Parental preferences play a significant role in treatment decisions, though not always considered decisive.
- Findings support incorporating parental input into treatment planning for extremely preterm infants.
Aim:
To conduct a survey of the attitude towards treatment of extremely preterm infants by comparing the attitude towards life-saving treatment between a group of parents of extremely preterm children and parents in the general population. The importance the two groups of respondents assigned to parental preferences was also investigated.
Methods:
A Danish national cohort of children born from 1994 to 1995 with a birthweight below 1000 g or a gestational age below 28 wk were assessed in a 5-y follow-up study including a reference group of children born at term. The parents of the children were given a sequence of case vignettes presenting different clinical situations, which formed part of a questionnaire.
Results:
More than 80% of 222 possible index respondents and 76 possible reference respondents fulfilled the vignettes. Both groups of respondents were positive towards life-saving treatment of extremely preterm infants. The recommendations given by both groups were significantly influenced by the hypothetical child's risk of having a serious handicap and the parents' preferences. The results suggest that parents of extremely preterm children do not have a more conservative attitude towards life-saving treatment of extremely preterm infants than parents in the general population, and also support the view that parents' preferences should influence treatment decisions; although many believe that these should not be decisive.
Conclusion:
Compared to the general population, parents of children born extremely preterm did not express a more conservative attitude towards life-saving treatment of extremely preterm infants.
