From: Factors influencing the care provided for periviable babies in Australia: a narrative review
Study author | Date | Population | Sample size | Methodology | Outcome of study |
---|---|---|---|---|---|
Mulvey et al. [38] | Published 2001 | Obstetricians in hospitals with Level 3 NICU, No Northern Australian participants | 89 participants, 48Â % response rate | Survey | Majority would always discuss resuscitation from 23Â weeks. Majority underestimate survival. Paediatric opinion then parental opinion used to inform decisions. |
Gooi et al. [39] | Published 2001 | Obstetricians from hospitals providing level 2 neonatal care | 174 participants, 75 % response rate | Survey | Median for resuscitation 24 weeks gestation. Refer to tertiary unit over 24 weeks except in West Australia and Victoria – 23 weeks |
De Garis et al. [36] | Published 1987 | Neonatologists from all 18 NICU in Australia | 51 participants, response rate not given | Survey, some open ended questions | Majority under estimate survival. Majority offer full resuscitation over 24Â weeks gestation, consider later withdrawal of care if neurological concern |
Oei et al. [40] | Study 1997–1998 Published 2000 | All neonatologists in Australia | 71 participant neonatologists 93 % response rate , 41 neonatal nurse participants, 74 % response rate | Survey, some open ended questions | Doctors median age for care 24 weeks- range 22–25 Nurses median age of care 25 weeks- range 23–28 Parental opinion should influence resuscitation but majority would overrule parents at 25 weeks Doctors more accurate estimate of survival and morbidity |
Munro et al. [37] | Published 2001 | 100 neonatologists in Australia | 70 % response rate | Survey | Majority always counseled over 23 weeks and would give mortality and morbidity data. Obstetricians’ main influence in decision to provide resuscitation. Consider parental opinion from 23 to 25 weeks |
Martinez et al. [43] | Study 1999 Published 2005 | Part of large Pacific Rim study comparing practice in different countries. Neonatologists throughout Australia | Participant number unclear, 68Â % response rate | Survey | Obstetric opinion and previous parental infant loss would be main influences of what counseling provided. Majority said that family should be decision makers for resuscitation where parents and doctor disagreed |
Partridge et al. [26] | Study 1998 Published 2005 | Part of large Pacific Rim study comparing practice in different countries. Parents in Melbourne Australia. Babies under 1501Â g, mean gestation 29.2Â weeks | 51 Australian parents response rate unknown | Survey (by structured telephone interview) | 74Â % felt that physicians had made all resuscitation decisions alone. Majority of babies had done better than expected from the antenatal counseling prognosis. Less than 50Â % felt that ante-natal counseling adequate |