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Antenatal consultations for preterm labour: how are future mothers reassured?
  1. Nathalie Gaucher1,2,3,
  2. Sophie Nadeau4,
  3. Alexandre Barbier5,
  4. Antoine Payot2,3,6
  1. 1 Division of Pediatric Emergency Medicine, CHU Sainte-Justine, Université de Montréal, Montreal, Canada
  2. 2 Clinical Ethics Unit, CHU Sainte-Justine, Université de Montréal, Montreal, Canada
  3. 3 CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada
  4. 4 Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire de Québec, Centre Mère Enfant Soleil, Université Laval, Quebec, Canada
  5. 5 Division of Neonatology, Department of Pediatrics, Royal Victoria Hospital, McGill University, Montreal, Canada
  6. 6 Division of Neonatology, Pediatrics Department, CHU Sainte-Justine, Université de Montréal, Montreal, Canada
  1. Correspondence to Dr Nathalie Gaucher, Division of Pediatric Emergency Medicine, Clinical Ethics Unit, Department of Pediatrics, CHU Sainte-Justine, 3175 Chemin de la Côte Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada; nathalie.orr.gaucher{at}umontreal.ca

Abstract

Objective To evaluate whether the antenatal consultation for preterm labour worries or reassures women, and to identify factors contributing to these feelings.

Design This is a prospective survey study from April 2012 to September 2013. This mixed-methodology tool was co-constructed with patients and first tested in a single-centre pilot study.

Setting Three university-affiliated, tertiary care, high-risk obstetrics inpatient units in Quebec, Canada.

Participants Women hospitalised with threatened preterm labour between 26 and 32 weeks’ gestational age completed the survey within 72 hours of an antenatal consultation by neonatology. 341 women were invited to participate and 226 mothers completed the survey (72% response rate), at a median gestational age of 30 weeks.

Main outcome measures Participant worry, reassurance and change in perception after the antenatal consultation were the main outcome measures. Multivariable logistic regression was used to identify factors associated with these outcomes.

Results 23% of participants were worried by the consultation, and 87% were reassured by it. Lower gestational age and higher maternal education were associated with feeling worried (adjusted OR=0.83, 95% CI 0.70 to 0.99; and adjusted OR=2.15, 95% CI 1.04 to 4.44, respectively). Longer consultations were associated with reassurance (adjusted OR=8.21, 95% CI 2.67 to 25.26). Women were reassured by (1) feeling well informed about prematurity with optimistic outlooks, and (2) a trusting and reassuring expert neonatology team. High-quality interactions with neonatologists were associated with reassurance, while poorer communications were associated with feelings of worry.

Conclusions To be reassuring, neonatologists should strive to establish a trusting relationship with mothers, in which realistic and clear, but optimistic, information is offered.

  • neonatology
  • ethics

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Footnotes

  • Contributors NG participated in the conception and design of the study, analysed and interpreted the data, drafted the manuscript, and has approved the manuscript as submitted. She had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    SN participated in the conception and design of the study, interpreted the data, revised the manuscript, and has approved the manuscript as submitted.

    AB participated in the conception and design of the study, interpreted the data, revised the manuscript, and has approved the manuscript as submitted.

    AP participated in the conception and design of the study, analysed and interpreted the data, drafted the manuscript, and has approved the manuscript as submitted.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The institutional review boards of the three participating healthcare institutions approved this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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