title: Factors influencing the uptake of neonatal bereavement support services - Findings from two tertiary neonatal centres in the UK.
abstract: BACKGROUND
  Research on perinatal bereavement services is limited. The aim of the study was to compare the uptake of bereavement support services between two tertiary neonatal units (NNU), and to investigate influencing factors.
  
  
  METHODS
  The medical and bereavement records of all neonatal deaths were studied from January 2006 to December 2011. Data collected included parent and baby characteristics, mode of death, consent for autopsy and bereavement follow-up. The categorical data were compared by chi-square or Fisher's exact test and continuous data by Wilcoxon signed-rank test; a multivariable regression analysis was performed using STATA 12.0.
  
  
  RESULTS
  The neonatal deaths of 297 babies (182 in NNU1 and 115 in NNU2) with full datasets were analysed. Baby characteristics were similar between units except for lower median gestational age in NNU1 (p = 0.03). Significantly more NNU1 parents were non-Caucasian (p < 0.01), from lower socio-economic status (p = 0.01) and had previous stillbirth/miscarriage (p = 0.03). More babies had care withdrawn in NNU2 (p < 0.01). A significantly higher proportion of parents from NNU1 (61 %) attended bereavement follow-up compared to NNU2 (34 %; p < 0.01). On multivariable analysis, significantly more parents who were married or co-habiting (p = 0.02) and consented for an autopsy (p = 0.01) attended bereavement services.
  
  
  CONCLUSIONS
  Uptake of bereavement services varied between the two NNUs, which could be due to differences in the ethnic and socio-economic mix of the population. Significantly more parents who were married or co-habiting, or consented for autopsy, attended bereavement follow up services.
authors.affiliation: Neonatal Unit, Homerton University Hospital NHS Foundation Trust, Homerton Row, London, E9 6SR, United Kingdom.|Centre for Paediatrics, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.|Neonatal Unit, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Jayanta
authors.initials: J
authors.lastname: Banerjee
authors.affiliation: Neonatal Unit, Homerton University Hospital NHS Foundation Trust, Homerton Row, London, E9 6SR, United Kingdom.
authors.forename: Charanjit
authors.initials: C
authors.lastname: Kaur
authors.affiliation: Neonatal Unit, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK.
authors.forename: Sridhar
authors.initials: S
authors.lastname: Ramaiah
authors.affiliation: Neonatal Unit, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK.
authors.forename: Rahul
authors.initials: R
authors.lastname: Roy
authors.affiliation: Neonatal Unit, Homerton University Hospital NHS Foundation Trust, Homerton Row, London, E9 6SR, United Kingdom. narendra.aladangady@homerton.nhs.uk.|Centre for Paediatrics, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. narendra.aladangady@homerton.nhs.uk.|Department of Paediatrics, SDM Medical College and Hospitals, Dharwad, India. narendra.aladangady@homerton.nhs.uk.
authors.forename: Narendra
authors.initials: N
authors.lastname: Aladangady
mesh_terms: D001344:Autopsy; D001601:Bereavement; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D066088:Infant Death; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D018743:Perinatal Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012944:Social Support; D012959:Socioeconomic Factors; D050497:Stillbirth / Q000523:psychology
keywords: Autopsy; Bereavement follow up; Death; Ethnicity; Neonatal; Socio-economic