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Assessing shared decision making during antenatal consultations regarding extreme prematurity

Journal of Perinatology volume 43, pages 29–33 (2023)Cite this article

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Abstract

Objective

To assess whether antenatal decisions regarding the neonatal care at birth for extremely preterm infants are more likely to be made when using shared decision-making (SDM)-style consultations compared to standard consultations.

Study design

In 2015, we implemented a clinical practice guideline promoting SDM use within antenatal consultations in our single-centre university-based perinatal unit. We conducted a prospective cohort study with a retrospective chart review based on data collected from all pregnant women presenting to obstetrical triage between 22 + 0 and 25 + 6 weeks gestation between September 2015 and June 2018.

Result

Two-hundred-and-seventeen cases presented; 137 received antenatal consultations with 82 (60%) being SDM-style. Decisions were frequently made (88%; 120/137) after the consultations, with no significant difference between consultation style (RR 1.08, 95% CI [0.95–1.26], p = 0.28).

Conclusion

The provision of either an SDM-style or a standard antenatal consultation seemed to comparably facilitate the reaching of a care decision.

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Fig. 1: Consultation and decision outcomes.
Fig. 2: Use of SDM-style consultations (based on documentation assessment) during implementation period.

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Data availability

Data available on request from the authors.

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Funding

This work was supported by a Children’s Hospital of Eastern Ontario Research Growth Award, grant number 20140195, a University of Ottawa Summer Studentship Award and Children’s Hospital of Eastern Ontario Research Institute Summer Studentship Award, grant number 20140173.

Author information

Authors and Affiliations

  1. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

    Sharon Ding, Thierry Daboval, Brigitte Lemyre, Nick Barrowman & Gregory P. Moore

  2. CHEO Research Institute, Ottawa, ON, Canada

    Sharon Ding, Vid Bijelić, Thierry Daboval, Sandra Dunn, Brigitte Lemyre, Nick Barrowman & Gregory P. Moore

  3. Department of Obstetrics, Division of Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada

    Thierry Daboval, Brigitte Lemyre & Gregory P. Moore

  4. Department of Paediatrics, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

    Thierry Daboval, Brigitte Lemyre & Gregory P. Moore

  5. School of Nursing, University of Ottawa, Ottawa, ON, Canada

    Sandra Dunn

Authors
  1. Sharon Ding
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  2. Vid Bijelić
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  3. Thierry Daboval
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  4. Sandra Dunn
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  5. Brigitte Lemyre
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  6. Nick Barrowman
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  7. Gregory P. Moore
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Contributions

SD co-designed the study, organized and carried out the training and scoring process, carried out the analyses, co-drafted the initial manuscript, and approved the final manuscript as submitted. VB co-designed the study, carried out the analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. TD co-designed the study, reviewed and revised the manuscript, and approved the final manuscript as submitted. SD co-designed the study, reviewed and revised the manuscript, and approved the final manuscript as submitted. Dr. Lemyre co-designed the study, reviewed and revised the manuscript, and approved the final manuscript as submitted. NB co-designed the study, carried out the analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. GPM conceptualized and co-designed the study, supervised the logistics of the study, co-drafted the initial manuscript (without honorarium or financial gain), and approved the final manuscript as submitted.

Corresponding author

Correspondence to Gregory P. Moore.

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The authors declare no competing interests.

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Ding, S., Bijelić, V., Daboval, T. et al. Assessing shared decision making during antenatal consultations regarding extreme prematurity. J Perinatol 43, 29–33 (2023). https://doi.org/10.1038/s41372-022-01542-y

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