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Decision-Making for Extremely Preterm Infants: A Qualitative Systematic Review.

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This study synthesizes decision-making factors in antenatal consultations for threatened preterm birth. Clear communication and partnership building are key for personalized infant care decisions.

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Area of Science:

  • Maternal-Fetal Medicine
  • Healthcare Decision-Making
  • Qualitative Research Synthesis

Background:

  • Antenatal consultations for threatened preterm delivery at the margin of gestational viability involve complex decision-making.
  • Understanding the perspectives of both healthcare providers and parents is crucial for effective shared decision-making.

Approach:

  • A systematic review of qualitative literature from 1990 to July 2021 was conducted.
  • Studies were screened and evaluated for quality, with thematic analysis used to identify key decision-making elements.
  • Data from 25 articles, representing 504 providers and 352 parents, were synthesized.

Key Points:

  • Four main themes emerged: factors influencing decisions, information sharing, partnership building, and the decision-making process itself.
  • Discrepancies exist between parents' and providers' views on the most critical elements of decision-making.
  • Effective shared decision-making requires clear, honest, and balanced information exchange.

Conclusions:

  • Qualitative insights can guide providers in antenatal counseling for threatened preterm birth.
  • Focusing on partnership and avoiding dichotomized options supports personalized infant care decisions.
  • Improved communication strategies can enhance the shared decision-making process for families facing preterm delivery.