CPS urges shared decision-making with families of extremely preterm infants
Mar 2 2017
OTTAWA— When families are facing the birth of an extremely preterm infant, they will likely have many complex and sometimes difficult decisions to make. A new statement from the Canadian Paediatric Society (CPS) recommends a shared decision-making approach, involving a number of specialized health professionals and the expectant parents, to help families develop a plan that is in the best interests of their infant and aligned with their values and preferences.
The statement, released today, focuses on infants to be born between 22 and 25 weeks’ gestational age, but acknowledges that gestational age should not be the only factor in decision-making. Other medical factors relative to the fetus, along with the social and ethical values of the family will also be involved in the decision-making process.
“As health care providers, we play a very important role in the shared decision-making process,” says Dr. Gregory Moore, co-author of the statement. “We must help each family understand any biological or medical risks, and to account for their own social and familial circumstances that may influence the infant’s life.”
The statement recommends that families receive individualized, accurate information about prognosis and the uncertainties related to an estimation of such prognosis. Health professionals should help parents understand what decisions need to be made and what the options are, then support them through the process.
The position statement was reviewed by practicing clinicians from both inside and outside of the Neonatal Intensive Care Unit environment, as well as Canadian families with lived experience.
“There has never been one clear and simple way to approach anticipated extremely preterm births,” said Dr. Moore. “By involving medical experts and families in the development of this statement, we’re aiming to provide recommendations reflective of the needs of Canadians facing these difficult circumstances.”
The survival rate of infants born at 22 weeks gestational age has increased over the last few years and the new recommendations remind health care providers that most births offer the opportunity for a family to welcome a child into the world with hope and happiness, even one born extremely preterm.
About the Canadian Paediatric Society
The Canadian Paediatric Society is a national advocacy association that promotes the health needs of children and youth. Founded in 1922, the CPS represents more than 3,000 paediatricians, paediatric subspecialists and other child health professionals across Canada.