title: Parents' Prenatal, Onward, and Postdischarge Experiences in Case of Extreme Prematurity: When to Set the Course for a Trusting Relationship between Parents and Medical Staff.
abstract: OBJECTIVE
  This article aims to investigate the impact of prenatal counseling on subsequent parents' experiences during in-patient care of their infant(s) and whether feelings of parents with deceased infants are different in principle.
  
  
  METHODS
  A questionnaire was sent to 99 families with a child born less than 26 weeks' gestational age at Medical School Hanover 2000-2008. Statistical analysis was performed using Fisher exact t test and chi-square tests in IBM SPSS Statistics for Windows, Version 20.0.
  
  
  RESULTS
  Response rate was 73%. Parents with solely surviving children significantly more often answered the questionnaire (p < 0.001). Regardless of the infants' outcome, parents who felt well involved in prenatal decision making significantly more often also felt adequately involved in postnatal treatment of their child (p = 0.006) and would again decide on life-sustaining treatment of an extremely premature infant (p = 0.007). Furthermore, they were significantly less dubious about the treatment of their baby (p = 0.013) than parents not feeling sufficiently involved. Significantly fewer parents with only surviving child(ren) decided to have another baby later than parents with at least one deceased child (p = 0.004).
  
  
  CONCLUSIONS
  This study stresses the impact of prenatal counseling and shows that, regardless of outcome, the course of a trusting relationship between parents and health care team is already set before birth.
authors.affiliation: Department of Pediatric Pulmonology, Allergology and Neonatology, Hanover Medical School, Hanover, Lower Saxony, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Bohnhorst
authors.affiliation: Department of Anesthesiology, Brunswick Hospital, Brunswick, Melbourne, Australia.
authors.forename: Tobias
authors.initials: T
authors.lastname: Ahl
authors.affiliation: Department of Pediatric Pulmonology, Allergology and Neonatology, Hanover Medical School, Hanover, Lower Saxony, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Peter
authors.affiliation: Department of Pediatric Pulmonology, Allergology and Neonatology, Hanover Medical School, Hanover, Lower Saxony, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Pirr
mesh_terms: D001294:Attitude to Health; D003376:Counseling; D003657:Decision Making; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008503:Medical Staff; D010290:Parents; D010358:Patient Participation; D011295:Prenatal Care; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires; D017741:Survivors; D035502:Trust