The following is a summary of “Decision-Making for Extremely Preterm Infants: A Qualitative Systematic Review” published in the December 2022 issue of Pediatrics by Krick et al.


For a study, researchers sought to summarize and discuss key factors in the decision-making process for a threatened preterm birth at the edge of gestational viability.

The following databases were searched: PubMed, EMBASE, Web of Science, and CINAHL Plus. From 1990 until July 2021, all qualitative decision-making literature was covered. Utilizing the Critical Appraisal Skills Programme checklist, two authors independently screened and assessed each study; papers of moderate to high quality were included. Each qualitative article’s data was extracted using a technology that they created, and the information was then analyzed and described using a theme approach.

For the purpose of the final evaluation, 25 articles that incorporated the opinions of 504 professionals and 352 parents were chosen. Themes of decision-making considerations, information sharing, partnership building, and decision-making itself emerged from the thematic analysis as the four key themes that best captured the experience of health care providers and parents involved in decision-making. The most crucial factors for the decision-making process were not always agreed upon by parents and caretakers. English-language publications were not included in the articles.

Providers can be informed and led during the collaborative decision-making process by qualitative literature emphasizing key elements that are significant during prenatal counseling. Providers may use prenatal consultation to arrive at individualized decisions for each newborn by communicating clear, honest, and balanced information; avoiding artificially dichotomized alternatives; and concentrating on relationship-building with families.

Reference: jpeds.com/article/S0022-3476(22)00666-7/fulltext